| NPI | 1881172245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA M KENRDID President 700-400-7191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: NV NV20171509097) |
| 207Q00000X Family Medicine (Licence: NV NV20171509097) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: NV NV20171509097) | |
| 251B00000X Case Management (Licence: NV NV20171509097) | |
| 251S00000X Community/Behavioral Health (Licence: NV NV20171509097) | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: NV NV20171509097) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: NV NV20171509097) | |
| 363LF0000X Nurse Practitioner Family (Licence: NV NV20171509097) | |
| Enumeration Date | 2018-07-29 |
| Last Update Date | 2021-05-13 |