| 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 |