| NPI | 1972054567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEE THOMAS Owner 702-321-8984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20161570483) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |