| NPI | 1205509205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP C STAFFORD CEO 702-754-9063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC1900X Psychologist, Counseling | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2021-07-27 |