| NPI | 1174865331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE MARQUEZ Direct Supervisor 702-472-3137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV P50-03087-2-164460) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |