| NPI | 1376997627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE A EDDINS Chief Administrator 702-489-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-02-16 |