| NPI | 1306402045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIORGE AREVALO-BLANCO Manager 702-832-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-05-17 |