| NPI | 1164072427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP ALLEN Executive Director 702-767-8672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |