| NPI | 1093249484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERCEDES KENISHA WARD Owner 602-639-3506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171166360) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |