| NPI | 1467847657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIVELLE NUNEZ-RUCKER Owner 702-750-9387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV 01306) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 01316-Intern) |
| 207R00000X Internal Medicine (Licence: NV 6766) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2018-03-17 |