| NPI | 1376189076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE KELLY Director 702-493-5998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-11-25 |