| NPI | 1003220401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M HAYNES Owner 505-238-9551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-05833) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |