| NPI | 1275017956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORINE HAYNES Partner 702-443-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2019-11-02 |