| NPI | 1639608532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL BERNARD THOMAS President 702-556-4277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV C201705250061) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-06-06 |