| NPI | 1841848595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER COMPLOT Administrator 702-325-5314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2021-08-19 |