NPI | 1407996002 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN A JENKINS COO 702-385-2090 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 100010IN) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2024-07-31 |