| NPI | 1730979055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEREE ANNTIONETTE ROLLING Dispensing Nurse 702-703-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |