| NPI | 1649039942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANDERSON CEO 702-728-0528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-05-28 |