| NPI | 1649898107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY KAPPELER Director 702-259-1903 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |