| NPI | 1003633603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCHESCA VAN BUREN Chief Administrative Officer 702-685-0877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| 207P00000X Emergency Medicine | |
| 251S00000X | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-30 |