NPI | 1578789020 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS C WAGNER Clinical Director 702-248-6290 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 01761-C) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2020-08-22 |