| NPI | 1093255762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYANDA KERRIAN DOVE Manager 702-561-5015 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171130611) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |