| NPI | 1336763903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYZINE AYALA Managing Member 702-980-9624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |