| NPI | 1922432145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERNORIA P CHILDRESS Owner/Direct Supervisor 702-488-7086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NV NV20131504676) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |