| NPI | 1710635545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARYSSA IKEHARA Owner 775-287-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2022-03-10 |