| NPI | 1043922149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMEKA GREEN Owner 702-695-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2022-12-20 |