| NPI | 1518451251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY RAY DIQUARTO Program Administrator 775-233-5082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2018-06-17 |