| NPI | 1043515570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A. PREMSELAAR President 702-358-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5782C) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |