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3650 Warren Way # B1 Reno NV 89509-5240 | |
| (775) 470-8347 | |
| (775) 823-4099 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3650 Warren Way # B1, Reno, Nevada |
| Authorized Official Name and Position | John Joseph Pangallo (OWNER) |
| Authorized Official Contact | 7754708347 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3650 Warren Way # B1 Reno NV 89509-5240 Ph: (775) 470-8347 | 3650 Warren Way # B1 Reno NV 89509-5240 Ph: (775) 470-8347 |
| NPI Number | 1336676675 |
|---|---|
| Provider Enumeration Date | 05/17/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336676675 | NPI | - | NPPES |
| 101YP2500X | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | CI0265 (Nevada) | Primary |
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