| 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 |