| NPI | 1104359488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA HOWARD Owner 702-589-1057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2022-07-21 |