| NPI | 1124731401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CARILLO Biller 702-569-7244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-01-02 |