| NPI | 1528216066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE GRAY Personal Care Attendant 702-813-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV 5626213167) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |