| NPI | 1073898094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNNYCE DAWSON Owner 702-812-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV2010673467) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2011-10-21 |