| NPI | 1063910743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORISSA M ONEAL Owner 702-553-8685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NV NV20181075656) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-30 |