| NPI | 1891203352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHI BLACK Director 702-612-2839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181045451) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-06-16 |