| NPI | 1265206742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MARTIN Medical Director 702-324-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2024-10-27 |