| NPI | 1336932862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUANIKA S SIMPSON-JACKSON Administrator 702-417-4702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QR1300X Clinic/Center, Rural Health | |
| 261Q00000X Clinic/Center | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QG0250X Clinic/Center, Genetics | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |