| NPI | 1962964213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS BROOKS Board Member 702-852-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-08-08 |