| NPI | 1417599184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE MAH COO 702-808-5739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2022-03-31 |