| NPI | 1962900548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR DZUGAS Owner 702-695-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171770226) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |