| NPI | 1538345038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEASA CARTER Manager 775-336-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV 787222) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |