| NPI | 1558106054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MALDONADO Owner 702-296-9687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-08-05 |