| NPI | 1033809256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THI HOANG Billing Agent 702-205-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-10-28 |