| NPI | 1750793766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE INFANTE Therapist 702-324-9156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 01263) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NV 01263) |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2014-05-24 |