| NPI | 1336896323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVE RODRIGUEZ Credentialing Manager 702-752-2134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist, Clinical | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0812X Clinical Nurse Specialist, Psych/Mental Health, Community | |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |