| NPI | 1255756334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWANDA STEVENS Manager 702-217-1292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20141085404) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |