| NPI | 1548154842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN CORTEZ Lead Credentialing Specialist 702-473-9841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2025-07-23 |