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Mr. Jack Gary Golla, QBA
Community/Behavioral Health Agency in Carson City, Nevada
NPI 1780985721

Jack Gary Golla is a Community/Behavioral Health Agency based in Carson City, NV. Jack Gary Golla practices in Carson City, NV and has the professional credentials of QBA. The NPI Number for Jack Gary Golla is 1780985721 and holds a License No. FF467210 (Nevada).

The current practice location address for Jack Gary Golla is 670 Washoe Dr, Carson City, NV and can be reached out via phone at 775-849-3165 and via fax at 775-849-9425.

Location: 670 Washoe Dr, Carson City, NV, 89704-9528
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780985721
Provider Name
Jack Gary Golla
Credential
QBA
Provider Entity Type
Individual
Gender
Male
Address
670 Washoe Dr, Carson City, NV, 89704-9528
Phone Number
775-849-3165
Fax Number
775-849-9425
Provider Enumeration Date
11/08/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9005043219 05 NV
institution
Provider Business Practice Location Address Details
Address
670 Washoe Dr
City
Carson City
State
Nevada
Zip
89704-9528
Phone Number
775-849-3165
Fax Number
775-849-9425
person
Provider Business Mailing Address Details
Address
670 Washoe Dr
City
Carson City
State
Nevada
Zip
89704-9528
Phone Number
775-849-3165
Fax Number
775-849-9425
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
FF467210 (Nevada)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
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670 Washoe Dr,
CARSON CITY, NV
89704-9528
775-849-3165
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