| NPI | 1417661356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKAUWRA SANDOVAL Program Director 702-683-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |