| NPI | 1659774446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA ANGELA MIRANDA Owner 702-204-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV CPC 0049) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |