| NPI | 1215558143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MIX-TESMER Owner 702-673-7796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2021-02-19 |