| NPI | 1558843318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIUSSKA CAMEJO PEREZ Manager 702-330-7844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV2018161353) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |