| NPI | 1326354309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOMMER THYME BERGDALE Co Owner 702-376-0024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 5554-C) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |