| NPI | 1083966634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD C MOORE Owner 702-380-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV NV20121587339) |
| Enumeration Date | 2012-10-07 |
| Last Update Date | 2012-10-07 |