| NPI | 1982398053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLESTER MARTIN Biller/Coder 775-745-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 174200000X Meals | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |