| NPI | 1629405840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BESCHELLE JUANMIA LOCKHART Owner 702-209-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 251S00000X | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2024-03-07 |