| NPI | 1912895269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI VERNETTE BASS Compliance 702-591-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |