| NPI | 1821674664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN TAYLOR Manager 702-800-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |