| NPI | 1588259972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY KAPPELER Director 702-259-1903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-03-08 |