| NPI | 1568802742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA WADE CEO/Owner 702-882-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2019-09-23 |