Provider Demographics
NPI:1245825140
Name:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Entity type:Organization
Organization Name:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT III
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-682-8686
Mailing Address - Street 1:1664 N VIRGINIA ST
Mailing Address - Street 2:MAILSTOP 0296
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0001
Mailing Address - Country:US
Mailing Address - Phone:775-682-8686
Mailing Address - Fax:775-784-1126
Practice Address - Street 1:1664 N VIRGINIA STREET CAIN HALL ROOM 239
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-682-8686
Practice Address - Fax:775-784-1126
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-03
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty