Provider Demographics
NPI:1104482918
Name:WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION
Entity type:Organization
Organization Name:WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-783-3081
Mailing Address - Street 1:1107 US HIGHWAY 395 N
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5304
Mailing Address - Country:US
Mailing Address - Phone:775-782-1630
Mailing Address - Fax:775-782-1632
Practice Address - Street 1:1107 US HIGHWAY 395 N
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5304
Practice Address - Country:US
Practice Address - Phone:775-782-1630
Practice Address - Fax:775-782-1632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHOE BARTON MEDICAL CLINIC A NEVADA NONPROFIT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-16
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3986-RUH-20OtherFACILITY LICENSE