Basic Information
| Provider Information | |||||||||
| NPI: | 1245781160 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDTRANS BEHAVIORAL NEVADA CASAL, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3312 W CHARLESTON BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022917121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 850 MILL ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7755386700 | ||||||||
| FaxNumber: | 7756885878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2016 | ||||||||
| LastUpdateDate: | 09/13/2022 | ||||||||
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| AuthorizedOfficialLastName: | JENNINGS | ||||||||
| AuthorizedOfficialFirstName: | SAADIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 7022917121 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.