NPI | 1801308655 |
---|---|
Entity Type | Organization |
Authorized Contact | LOUIE DANIEL TAQUIQUI Owner 702-806-5198 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171436936) |
Enumeration Date | 2017-11-02 |
Last Update Date | 2017-11-02 |