| NPI | 1033908413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY JACKSON Managing Member 702-268-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 251V00000X Voluntary or Charitable | |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |