NPI | 1578276507 |
---|---|
Entity Type | Organization |
Authorized Contact | JADE WILSON Owner 702-713-3514 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-01-04 |
Last Update Date | 2023-01-04 |