| NPI | 1902218316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COOPER Manager 702-979-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20141334354) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |