NPI | 1982415493 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA JO COHEN Owner/Provider 702-580-2800 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2025-01-15 |
Last Update Date | 2025-03-19 |