| NPI | 1184060261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUENTA KIRBY Manager 702-682-3586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV nv20131280997) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-05-16 |