| NPI | 1104974500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA CRUZ BASALLO Administrator 775-323-4696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NV 285AGC12) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2016-02-16 |