NPI | 1790212900 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE CHADDICK Owner 702-931-8990 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NV CI0276) |
Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: NV NV20171307801) |
Enumeration Date | 2017-05-18 |
Last Update Date | 2017-05-18 |