| Golla Home | |
|
670 Washoe Dr Carson City NV 89704-9528 | |
| (775) 849-3165 | |
| (775) 849-9425 |
| Full Name | Golla Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 670 Washoe Dr, Carson City, Nevada |
| Authorized Official Name and Position | Jean Golla (MH TREATMENT HOME PROVIDER) |
| Authorized Official Contact | 7758493165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golla Home 670 Washoe Dr Carson City NV 89704-9528 Ph: (775) 849-3165 | Golla Home 670 Washoe Dr Carson City NV 89704-9528 Ph: (775) 849-3165 |
| NPI Number | 1992875157 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992875157 | NPI | - | NPPES |
| 100508067 | Medicaid | NV | |
| 006116513 | Medicaid | NV | |
| 100508066 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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