| NPI | 1518360072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB M MEARSE Nurse Practitioner 775-426-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA AP60510295) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-10-29 |