| NPI | 1457492332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE POULSON Program Manager 775-677-2216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-11-02 |