| NPI | 1033630710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KAHANANUI Director Of Clinic Operations 702-478-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |