| NPI | 1659019230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARTEIA JOHNSON HARRIS Manager 702-408-0934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2022-05-24 |