| NPI | 1114259355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE EDWARD JOHNSON Director 702-349-8258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5530-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 5530-C) |
| 251S00000X Community/Behavioral Health (Licence: NV 5530-C) | |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2011-03-22 |