| NPI | 1043911597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS TELLIS Director 702-205-0322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251E00000X Home Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-10-05 |