| NPI | 1629524004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANDRE PEARSON Owner 702-630-8321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20161356053) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |