| NPI | 1104123710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISHMAEL LATEEF THOMAS General Manager 702-885-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246Y00000X Spec/Tech, Health Info |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |