| NPI | 1780468439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMONTE BOLDEN Member 702-470-4839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-09-07 |