| NPI | 1154696722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRIONNA WILLIAMS Director 702-808-1261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| 302F00000X Exclusive Provider Organization | |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |