| NPI | 1881242949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD GAMBOA CEO 702-488-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2023-03-21 |