| NPI | 1801172358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN MOCK Billing/Insurance 775-331-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2011-10-28 |