| NPI | 1356980080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTE BOYKIN Owner 702-423-2925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-12-28 |
| Last Update Date | 2019-12-28 |