| NPI | 1710424288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MOORE Executive Director 702-380-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NV 5516ADA-6) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |