| NPI | 1588821938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAQUEL A CANNON Owner 702-346-1647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NV GF1253988850001) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |