| NPI | 1083797484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MASSMAN Owner 702-796-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone (Licence: NV 2569NTC-7) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-05-24 |