| NPI | 1790108264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA FRICKE Physician/CEO 702-804-9065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2023-03-07 |