| NPI | 1982996534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN PAULA FAJARDO Owner/Manager 702-343-3459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 20111195118) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2011-05-13 |