| NPI | 1558983361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EFRAIN RENE MORALES MORENO CEO 702-981-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |