| NPI | 1902330780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRENISE APRIL REID Owner 702-201-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |