| NPI | 1831970060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE GREEN Managing Member 702-813-5440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-08-06 |