| NPI | 1164660163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CHUCKALINE O'HARTZ Qmhp 702-750-0377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 5495c) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-01-29 |