| NPI | 1780161349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE TAIWO Manager/Owner 702-761-6567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181527395) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-09-28 |