| NPI | 1346558913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRIELLA DAVIS Owner 702-991-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20101336776) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |