| NPI | 1053158139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS TELLIS Manager 702-780-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251B00000X Case Management | |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |