| NPI | 1982263521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA D DAVIS President 702-373-8361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2019-06-07 |