29D1101053 CLIA NUMBER - NEVADA SKIES YOUTH WELLNESS CENTER

Laboratory Demographics

CLIA Number: 29D1101053

Facility Name: NEVADA SKIES YOUTH WELLNESS CENTER

Facility Address:
104 BIG BEND RANCH RD
WADSWORTH, NV
ZIP 89442
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Facility Phone Number: 520 562-4208

Facility Type: Other - YOUTH RESIDENTIAL TREATME

Certificate Type: Waiver

NPI Number: 1689800013

Taxonomy: 3245S0500X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

CLIA Record

Field Name	Field Value
CLIA Number	29D1101053
LAB Type	Other - YOUTH RESIDENTIAL TREATME
Facility Name	NEVADA SKIES YOUTH WELLNESS CENTER
Street	104 BIG BEND RANCH RD
City	WADSWORTH
State	NV
ZIP	89442
Phone	520 562-4208
CertificateType	4
CertificateEffectiveDate	6/18/2023
CertificateExpirationDate	6/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024