| NPI | 1982198164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE MARTIN Owner 702-469-1597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181441633) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |