| NPI | 1578002515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY MALLORY Owner 775-224-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |