| NPI | 1124726252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN F. JACKSON Managing Member 702-695-5643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-02-17 |