| NPI | 1841902483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN M JEFFERSON Owner 702-600-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |