| NPI | 1508228180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDIA C RICE Chief Operating Officer 702-445-0819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |