| NPI | 1770136962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES MALINIS Credentialing 702-410-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |