| NPI | 1407622525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRO MICHELLE HENDERSON Administrator 702-358-7754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |