| NPI | 1467272229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEONEL MORALES Owner 702-574-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |