| NPI | 1538831136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIKE OLISA Administrator 702-934-3309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |