| NPI | 1821209503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN SANDS Director Of Contracting 702-949-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 030000323) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |