| NPI | 1003265281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A EATON Student In An Organized Health Care 505-471-4752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |