| NPI | 1346528957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODIS THROWER Principle 702-336-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20111487272) |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2011-07-31 |