| NPI | 1861253841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZZAMIN CLARK Owner 702-354-1794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-11-18 |