| NPI | 1780578203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE RICKY WARD Managing Member 702-613-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-10 |