| NPI | 1164639571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARACELY GOMEZ Credentialing Specialist 775-786-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV not applicable) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-11-04 |