| NPI | 1831626662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDYE REANEZE MARSHALL Manager 702-523-8106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV LADC 1273) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |