| NPI | 1053792879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SUZANNE PAYNE Founder/Owner 702-834-4307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 20140769237-41) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |