NPI | 1457995813 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHNA DEAN Owner 702-713-9583 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
320800000X Community Based Residential Treatment Facility, Mental Illness | |
Enumeration Date | 2019-10-29 |
Last Update Date | 2024-01-09 |