| NPI | 1780133363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHOGANY J BOYD Owner 702-809-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20161565425) |
| Enumeration Date | 2016-09-24 |
| Last Update Date | 2016-09-24 |