| NPI | 1972172351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER MEEKS Manager 702-563-7037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |