| NPI | 1033661210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CARSON Manager 702-813-8894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2020-08-28 |