| NPI | 1073032090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISITACION T DELA PENA Administrator 702-324-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NV 358-AGC-25) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2022-07-21 |