Basic Information
| Provider Information | |||||||||
| NPI: | 1578739157 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAND UP HOMES FOR YOUTH NEVADA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 16TH ST | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802113959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033180311 | ||||||||
| FaxNumber: | 3033180288 | ||||||||
| Practice Location | |||||||||
| Address1: | 2725 YORI AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895024325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753290312 | ||||||||
| FaxNumber: | 7753290946 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2008 | ||||||||
| LastUpdateDate: | 05/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | WILSON | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIR OF ADMIN SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 3033180311 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 322D00000X | Y | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
No ID Information.