| NPI | 1598640872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYERA PORCHE Owner 702-202-2998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-09 |