| NPI | 1366724700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON RICHARD WATASE Owner 702-400-3819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |