| NPI | 1225495096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DE'ANGELO LOMAR CANDLER Owner 702-550-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20141429518) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |