| NPI | 1063945855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANAY JAZMINE BUSH Owner 702-396-1768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV C20170125-0988000000) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |