| NPI | 1871281469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE KELLY Owner 702-493-5998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2024-08-01 |