| NPI | 1215717483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL REYNOLDS Managing Member 702-917-3497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2025-01-14 |