| NPI | 1144708694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SIMBULAN Owner 702-405-9559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-12-13 |