| NPI | 1053963256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADE MARTIN Billing And Credentialing Manager 702-852-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 202D00000X Integrative Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 208D00000X General Practice | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-01-16 |