| NPI | 1629367065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRETTO E OWEN Staff 702-838-3889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV H1400104H113186) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-04-06 |