| NPI | 1013337195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN D. HUDSON Director 702-808-3581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 3577HIC-12) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |