| NPI | 1154017929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADEN HINES Managing Member 702-201-1058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 363LC1500X Nurse Practitioner, Community Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |