| 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 | 2024-05-21 |