| NPI | 1346661378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAMANI GODBOLT President 702-586-8015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20131642507) |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2014-03-31 |