| NPI | 1770082588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREENA R HARRIS Owner 702-488-1425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV nv20181083391) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |