| NPI | 1265012116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALEN WILLIAMS Owner 775-376-3246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2022-04-27 |