| NPI | 1255703948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MITZEL Owner 702-809-5157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20151592581) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |