| NPI | 1699293381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JINI MUHAMMAD Owner 702-799-9259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2017-09-02 |
| Last Update Date | 2022-07-21 |