| NPI | 1396011474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R MIKO RICHARDSON Secratary 702-562-8199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV nv20121179876) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-04-18 |