| NPI | 1306300579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUSOGA OLADIPO ALAGA Executive Manager 702-478-5541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |