| NPI | 1376731372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERCEDES LOS BANOS Resident Agent 702-355-0182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |