| NPI | 1225395148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADESA WADE Co Owner 702-501-8633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 20121134253) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |