NPI | 1316472277 |
---|---|
Doing Business As | N/A |
Entity Type | Organization |
Authorized Contact | MIKO BAKER Owner 702-502-4045 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171271300) |
Enumeration Date | 2017-04-27 |
Last Update Date | 2017-04-27 |