| NPI | 1467140160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZZAMIN CLARK CFO 702-812-0749 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |