| NPI | 1144787813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASIA COOK Owner 702-329-4991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2020-06-26 |