| NPI | 1285352211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY KAPPELER Director 702-259-1903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |