| NPI | 1013547587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M GODASI Marriage And Family Therapist 702-528-0898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-29 |