| NPI | 1215228887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JR FONOTISATELE Owner 702-998-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NV 6) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2022-07-21 |