| NPI | 1982080172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRIONNA L. WILLIAMS President/Director 702-808-1261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |