Jack, Edward Joseph
Jack, Edward Joseph is an sole proprietor health care provider with primary practice located at 3100 Mill St Suite 206, Reno NV 89502-2259. He recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as his primary health care specialty. Jack, Edward Joseph can be contacted via phone (775) 348-8048.Contact Information
Primary practice address
3100 Mill St Suite 206
Reno NV 89502-2259
Phone: (775) 348-8048
Fax: (775) 348-8043
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X |
Profile Details
| NPI number | 1568769867 |
|---|---|
| LBN Legal business name | Jack, Edward Joseph |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2011 |
| Last updated | Feb 22nd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568769867 | NPPES |
| Nevada | MEDICAID | 100511515 |
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