| NPI | 1457911737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTAL WILSON Owner 775-870-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |