| NPI | 1285258848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONTE BOLES Owner 702-581-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |