| NPI | 1215572201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH TODD PEHRSON Owner 702-823-9042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-14 |