| NPI | 1407110794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVANGELINE BRIGINO CRUZ Owner 702-480-4858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 4309agc10) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |