NPI | 1619480373 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES ALLEN DEVEREAUX Owner 760-267-8124 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171272163) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2017-11-15 |