| NPI | 1578050167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIDI JEFFERSON Owner 775-375-0579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181246191) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |