| NPI | 1346121019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMIKA FISFHER Owner 702-517-6327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |