| NPI | 1083194831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUENESHIA TILLMAN Owner 702-913-2708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181129548) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |