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Organization

MOXY UP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COLEEN LAWRENCE MSSL, EJD (EXECUTIVE DIRECTOR)
(775) 790-7022
Entity
Organization

Contact information

Practice address
789 TILLMAN LN SPC C, GARDNERVILLE, NV 89460-8201
(775) 790-7022
Mailing address
PO BOX 6322, GARDNERVILLE, NV 89460-4605
(775) 790-7022

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
01/11/2023
Last updated
02/03/2026
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