| NPI | 1588062772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENESA L HINES Manager 702-858-3160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20141775229) |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2014-12-20 |