| NPI | 1528200631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI DENISE HODGES Co Owner 702-308-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV PY0572) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-04-03 |