| NPI | 1568107548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CRAWFORD Owner 702-306-0323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-03 |