| NPI | 1093421919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA L DE VAY CFO 775-997-7579 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2024-08-23 |