| NPI | 1457653610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FULBROOK President 702-686-2069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 5767-C) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2013-09-09 |