| NPI | 1235627126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHANY EARL LESSIER Member 702-300-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181196318) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |