| NPI | 1669008876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THI HOANG Chief Revenue Office 702-205-8232 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2023-04-11 |