| NPI | 1477118198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA LAPUZ CLARK Owner 702-768-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |