| NPI | 1376058719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E CLEMONS Owner 702-708-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NV NV20016) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |