| NPI | 1225513104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRINCESS H RUSSELL Owner 702-862-9831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |