| NPI | 1902204225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL EDWARD RILEY Direct Supervisor 702-830-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV nv20141625823) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-19 |