| NPI | 1003588211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNISE PORTER Owner 702-927-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |