| NPI | 1174874739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE P HENDERSON Mft Intern 702-278-3622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV MI0366) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |