| NPI | 1023626694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE NYGREN Operations Manager 702-419-2592 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2022-03-23 |