1. Home
  2. Directory
  3. Nevada
  4. Reno
  5. Community Based Residential Treatment Facility Mental Illness
  6. NPI Profile

EDWARD JOSEPH JACK
NPI 1568769867
Community Based Residential Treatment Facility, Mental Illness in Reno, NV

Active since February 22, 2011
3100 MILL ST, SUITE 206, RENO, NV 89502(775) 348-8048(775) 348-8043 Get Directions Write a Review

NPPES record last updated: February 22, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edward Joseph Jack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD JOSEPH JACK (NPI 1568769867) is an individual community based residential treatment facility, mental illness provider in Reno, Nevada and active in the NPI registry since February 2011.

NPPES Registry Identity

NPI1568769867
Entity TypeIndividualMale
Primary Taxonomy320800000X
Provider Legal NameEDWARD JOSEPH JACK
Location Address3100 MILL ST, SUITE 206Reno, NV 89502-2259
Mailing Address3100 Mill St, Suite 206Reno, NV 89502-2259 · (775) 348-8048 · Fax (775) 348-8043
Phone(775) 348-8048
Fax(775) 348-8043
Sole ProprietorYes
Enumeration DateFebruary 22, 2011
✔ NPI 1568769867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
3100 MILL ST, Reno, NV 89502
Open in Google Maps ↗

Other Identifiers 1

Medicaid100511515NV

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VALERIA EILEEN NELSON
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, SUITE 206
RENO, NV 89502
Washoe County (775) 348-8048
ADETINKA AKINWALG
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, 206
RENO, NV 89502
Washoe County (775) 378-0671
NEDIRA ABUBAKER
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, 206
RENO, NV 89502
Washoe County (775) 378-0671
EBONY CHARISSE HILL
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, SUITE 206
RENO, NV 89502
Washoe County (775) 348-8048
ANTONIO MONTRY THOMAS
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, SUITE 206
RENO, NV 89502
Washoe County (775) 348-8048
DARRYL ANTHONY JACOBS
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, SUITE #206
RENO, NV 89502
Washoe County (775) 348-8048
MARCY FELLS
Community Based Residential Treatment Facility, Mental Illness
3100 MILL ST, 206
RENO, NV 89502
Washoe County (775) 378-0671
JAYCI VOS
Behavior Analyst
3100 MILL ST
RENO, NV 89502
Washoe County (408) 341-5542

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Jack's NPI number?

The NPI number for Edward Jack is 1568769867. It was assigned to this individual provider in the NPPES registry on February 22, 2011.

Where is Edward Jack located?

Edward Jack practices at 3100 Mill St Suite 206, Reno, NV 89502. The listed phone number is (775) 348-8048.

What is Edward Jack's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Edward Jack was last updated on February 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.