| NPI | 1053010579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADEN HINES Managing Member 702-202-1508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 252Y00000X Early Intervention Provider Agency | |
| 363LC1500X Nurse Practitioner Community Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |