NPI | 1609136035 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK JAMES BROXTERMAN Owner 702-429-2654 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV nv20121198867) |
Enumeration Date | 2012-05-18 |
Last Update Date | 2012-07-13 |