| NPI | 1922664465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE FRYE Proprietor 702-233-1094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |