| NPI | 1851743108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARTIN Owner 702-433-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 2000057-517) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NV 2000443810) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |