| NPI | 1790436541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA BARNES Managing Member / Administrator 702-845-2862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2022-01-24 |