| NPI | 1700558186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEOPHILUS MBI AKOH Administrator 775-335-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2021-10-04 |