| NPI | 1245124874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN HANKSTON Manager 702-863-6970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-06-06 |
| Last Update Date | 2025-06-06 |