| NPI | 1346863073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JSHAUNTAE MARSHALL Director 775-538-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X | |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |