| NPI | 1902603509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAIMOUNA CANTRALL Director 702-589-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-03-01 |
| Last Update Date | 2025-03-01 |