| NPI | 1265890206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI JACKSON Owner 702-570-3853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NV NV20161055721) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |