| NPI | 1992201354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PARRA Owner/Sole Proprietor 775-220-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 14433) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2019-10-21 |