| NPI | 1922675362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIAGNE ARIELLE R DUAVE CEO 702-588-1938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2021-06-04 |