| NPI | 1336650951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAJI D CLARK Owner 702-326-8716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2017-10-23 |