| St Four Square Clinicals Professional Corporation | |
|
100 N Arlington Ave Ste 340a Reno NV 89501-1248 | |
| (775) 238-3082 | |
| (844) 872-5607 |
| Full Name | St Four Square Clinicals Professional Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 N Arlington Ave Ste 340a, Reno, Nevada |
| Authorized Official Name and Position | Steven Thomas Huerta (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7752383082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Four Square Clinicals Professional Corporation 650 N Rose Dr Ste 472 Placentia CA 92870-7513 Ph: (775) 238-3082 | St Four Square Clinicals Professional Corporation 100 N Arlington Ave Ste 340a Reno NV 89501-1248 Ph: (775) 238-3082 |
| NPI Number | 1154196632 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154196632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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