| NPI | 1780861278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD BENARD SURRATT Program Manager 702-224-7593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2022-07-21 |