| NPI | 1427659465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCELYN N FURR-PATTON Member 702-204-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |