| NPI | 1861072456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD PAK Owner 702-981-0735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |