| NPI | 1801604277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAIMOUNA CANTRALL Business Owner 702-589-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2025-02-14 |