| NPI | 1861834186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASCAR CRUZ Owner 702-485-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2013-07-28 |
| Last Update Date | 2013-10-25 |