| NPI | 1750634432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK GREEN Owner 702-812-1405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV C20121018-1968) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |