| NPI | 1205417755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA JACKSON Lcadc 702-738-3395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |