Basic Information
| Provider Information | |||||||||
| NPI: | 1952665960 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARSON TAHOE BEHAVIORAL HEALTH SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 775 FLEISCHMANN WAY | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897032995 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754457756 | ||||||||
| FaxNumber: | 7758410304 | ||||||||
| Practice Location | |||||||||
| Address1: | 775 FLEISCHMANN WAY | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897032995 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754457756 | ||||||||
| FaxNumber: | 7758410304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2012 | ||||||||
| LastUpdateDate: | 06/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | BORGES | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7754457756 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 5827-S | NV | Y | Hospital Units | Psychiatric Unit |
No ID Information.