| NPI | 1144662206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE J TINES-BRAGGS Owner 702-203-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20131424530) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2016-01-08 |