| NPI | 1255864237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELESIA TEJERO Manager 702-826-6237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |