| NPI | 1043393309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANT MASSMAN Owner 702-399-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NV 1938NTC-10) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-06-06 |