| NPI | 1780189696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA AMOS Part Owner 702-737-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181099401) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2020-05-29 |