| NPI | 1194277939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MICHELLE WILSON Owner 702-376-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV C20160218-0098) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |