| NPI | 1922452150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALT YBARRA Owner 702-901-9079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: 190907AP) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |