| NPI | 1053059378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GALLIOS Office Manager 702-290-3235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-05-25 |