| NPI | 1043752678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN LEE Program Manager 702-444-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20161667128) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |