| NPI | 1336436914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA J. OVERBY Counselor/Psr 702-277-7703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV #0622) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2011-07-05 |