| NPI | 1063842516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LORENZO Medical Supervisor 702-630-9338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NV 2000333.62-101) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |