| NPI | 1700319993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL C TOLLIVER Manager 775-671-6427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |