| NPI | 1023656261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE HENSON Manager 775-412-8214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2020-04-08 |