| NPI | 1558847293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAHEESHA JOHNSON Owner 702-245-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |