| NPI | 1689923369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MARKELL STATEN President 702-750-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20121534450) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |