| NPI | 1952913790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN LAZO Member 702-727-9065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-08-22 |
| Last Update Date | 2020-08-22 |