| NPI | 1295374031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HYLIDA DENISE WILLIAMS Owner 702-815-0746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2020-05-14 |