| NPI | 1871091959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARONDA CONWAY Managing Member 702-824-3629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171544329) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-06-16 |