| NPI | 1710360714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINA PHIPPS Managing Member 1775-575-2284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 20151405713) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |