| NPI | 1417254202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JACKSON Program Manager 702-586-6870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NV 5450-C) |
| Additional Taxonomies | 251B00000X Case Management (Licence: NV 5450-C) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2012-05-08 |