| NPI | 1326656257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN KATHERINE GRAY Office Administrator 702-790-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-08-18 |