| NPI | 1922548460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVELL WORTHY Manager 702-957-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |