| NPI | 1487493565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUSIMI LOPEZ RAMOS Owner 702-510-9587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |