| NPI | 1689075780 |
|---|---|
| Other Name | KENNETH SMITH |
| Entity Type | Organization |
| Authorized Contact | KENNETH JAMES SMITH Admin 702-601-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |