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 |