| NPI | 1912596685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ANGEL RODRIGUEZ BAUZA Owner 702-810-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-01-15 |