| NPI | 1417410416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES MALINIS Credentialing Specialist 702-410-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |