| NPI | 1114373156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASIA MARIE BIENIEMY Basic Skills Trainer 702-979-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-09 |