| Emergency Youth Shelter | |
|
2101 Agency Rd Fallon NV 89406-7142 | |
| (775) 423-1132 | |
| (775) 423-3503 |
| Full Name | Emergency Youth Shelter |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 2101 Agency Rd, Fallon, Nevada |
| Authorized Official Name and Position | Cynthia E. Wachsmuth (CASE MANAGER) |
| Authorized Official Contact | 7754231132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergency Youth Shelter 2101 Agency Rd Fallon NV 89406-7142 Ph: (775) 423-1132 | Emergency Youth Shelter 2101 Agency Rd Fallon NV 89406-7142 Ph: (775) 423-1132 |
| NPI Number | 1184954604 |
|---|---|
| Provider Enumeration Date | 01/06/2010 |
| Last Update Date | 01/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184954604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | PY085 (Nevada) | Primary |
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