| NPI | 1740721505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORSCHETT WARD Manager 702-712-7689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |