| NPI | 1023322492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY PECK KANE Director 702-430-6206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2010-07-28 |