STATE OF NEVADA (NPI# 1417582230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417582230 |
| Entity Type | Organization |
| Organization Name | STATE OF NEVADA |
| Practice Address |
480 Galletti Way Bldg 8n Sparks NV 89431 |
| Mailing Address |
2655 Enterprise Dr Reno NV 89512 |
| Practice Telephone | 7756881633 |
| Practice Fax Number | 7756881640 |
| Mailing Telephone | 7756881600 |
| Mailing Fax Number | 7756881616 |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | DR. KAREN TORRY E GREENE (CLINICAL PROGRAM MANAGER II) |
| Authorized Official Telephone | 7756881649 |
| Authorized Official Credential | DBH, LCSW |
| Is Organization Subpart | Y |
| Parent Organization Name | SATE OF NEVADA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| PRTF North | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1316574064 | State of Nevada | Psychiatric Residential Treatment Facility | 2655 Enterprise Dr, Reno, NV 89512 | 2020-03-24 |
| 1114309432 | State of Nevada | Case Management | 3416 Goni Rd Bldg D, 132, Carson City, NV 89706-8008 | 2015-06-23 |
| 1699914887 | State of Nevada | Case Management | 775 Cornell Avenue, Suite A-1, Lovelock, NV 89419-0000 | 2009-02-11 |
| 1386805265 | State of Nevada | Public Health or Welfare | 1000 E Williams Street, #205, Carson City, NV 80701 | 2008-06-23 |
| 1558549972 | State of Nevada | Case Management | 100 Depot, #5, Caliente, NV 89008-0000 | 2008-02-07 |
| 1578741179 | State of Nevada | Case Management | 1665 Old Hot Springs Road, Suite 150, Carson City, NV 89706-0668 | 2008-02-06 |
| 1336203892 | State of Nevada | Public Health or Welfare | 1665 Old Hot Springs Rd Ste 157, Carson City, NV 89706-0663 | 2006-12-20 |
| 1184706012 | State of Nevada | Clinic/Center | 825 S Main, Tonopah, NV 89049-0494 | 2006-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF NEVADA RURAL CLINICS | 4126 Technology Way 2nd Fl, Carson City, NV 89706-2027 |
| Street Address |
480 GALLETTI WAY BLDG 8N |
| City | SPARKS |
| State | NV |
| Zip Code | 89431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245782036 | Danelli Taylor | Licensed Practical Nurse | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2016-10-27 |
| 1073138921 | Kyle Coss | Registered Nurse | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2020-06-16 |
| 1861020372 | Mary Ann Leglise | Registered Nurse | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2020-03-30 |
| 1427528454 | Jessica Crosby | Counselor | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2018-12-03 |
| 1992271423 | Kyle Gerber-winn | Counselor | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2018-10-23 |
| 1043706906 | Dana Skylar Gray | Counselor | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2018-07-03 |
| 1932635448 | Miguel Ramos | Counselor | 480 Galletti Way Bldg 8n, Sparks, NV 89431-5564 | 2017-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958033 | Jerome Johnson II | Behavioral Analyst | 3115 Saltern Way, Sparks, NV 89431 | 2019-12-09 |
| 1528520640 | Dynisha Bernee Richardson | Technician, Other | 616 Victorian Ave, Sparks, NV 89431 | 2019-04-05 |
| 1902376494 | Avalon Care Center-va Reno, LLC | Skilled Nursing Facility | 36 Battle Born Way, Sparks, NV 89431 | 2018-11-28 |
| 1669964128 | Abraham A Arellano | Behavioral Analyst | 2005 Probasco Way, Sparks, NV 89431 | 2018-05-31 |
| 1003335399 | Carresa Greer | Counselor | 390 Freeport Blvd #3, Sparks, NV 89431 | 2017-09-18 |
| 1689197444 | Fred Blauth Jr. | Counselor | 2105 Sullivan Ln, Sparks, NV 89431 | 2017-07-24 |
| 1548719255 | Adolescent Treatment Center | Community Based Residential Treatment Facility, Mental Illness | 480 Galetti Way, Sparks, NV 89431 | 2016-09-23 |
| 1124478862 | Kristina Schneider | Behavioral Analyst | 3230 Wedekind Rd, 50, Sparks, NV 89431 | 2016-06-14 |
| 1336506898 | Rikki Texter | Occupational Therapy Assistant | 1025 Robert Lane, Sparks, NV 89431 | 2016-01-28 |
| 1851760177 | Elizabeth Ojeda | Counselor | 490 Galletti Way, Building 8c, Sparks, NV 89431 | 2015-09-16 |
| Find all providers in zip 89431 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801167507 | Briarwood Treatment Center | Psychiatric Residential Treatment Facility | 480 Galletti Way, Sparks, NV 89431-5564 | 2012-01-26 |
| 1659448017 | State of Nevada | Psychiatric Residential Treatment Facility | 480 Galletti Way, Sparks, NV 89431-5564 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104424829 | Eden Treatment, LLC | Psychiatric Residential Treatment Facility | 7390 Edna Ave, Las Vegas, NV 89117-2902 | 2020-10-14 |
| 1316574064 | State of Nevada | Psychiatric Residential Treatment Facility | 2655 Enterprise Dr, Reno, NV 89512 | 2020-03-24 |
| 1043879083 | Eden Treatment, LLC | Psychiatric Residential Treatment Facility | 3636 Dutch Valley Dr, Las Vegas, NV 89147-6806 | 2019-06-12 |
| 1164903613 | Crc Ed Treatment LLC | Psychiatric Residential Treatment Facility | 2501 Holcomb Ranch Ln, Reno, NV 89511-9558 | 2018-08-23 |
| 1306338215 | Douglas Co and Unincorporated Towns | Psychiatric Residential Treatment Facility | 225 China Spring Rd, Gardnerville, NV 89410 | 2018-06-06 |
| 1871029082 | New Benchmark | Psychiatric Residential Treatment Facility | 1472 W Hwy 373, Amargosa Valley, NV 89020 | 2017-05-08 |
| 1174989578 | Aisha Marpa Santos | Psychiatric Residential Treatment Facility | 1219 Starstone Ct, Henderson, NV 89014-7899 | 2016-01-14 |
| 1063827749 | Kw Legacy Ranch, LLC | Psychiatric Residential Treatment Facility | 1760 Sr 318, Hiko, NV 89017-2215 | 2014-06-21 |
| 1962557975 | Crc Ed Treatment, Inc | Psychiatric Residential Treatment Facility | 1500 Pass Dr, Reno, NV 89509 | 2007-01-23 |
| 1811953003 | State of Nevada | Psychiatric Residential Treatment Facility | 6171 W Charleston Blvd, Bldg. #17, Las Vegas, NV 89146-1126 | 2006-04-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.