Edward Joseph Jack
Edward Joseph Jack is a Mental Illness Community Based Residential Treatment Facility in Reno, Nevada. Practices as a sole proprietor. Registered with an NPI since 2011.
- In the registry since
- 2011
Practice location Address checks out
3100 Mill St Ste 206Reno, NV 89502-2259
Phone: (775) 348-8048
Fax: (775) 348-8043
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Specialties & licences
| Mental Illness Community Based Residential Treatment Facility (primary) | Taxonomy 320800000X |
|---|
Record details
| NPI number | 1568769867 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 22, 2011 |
| Last updated in NPPES | February 22, 2011 |
| Mailing address | 3100 Mill St, Suite 206, Reno, NV 89502-2259 |
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