| NPI | 1003490269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA CORDOVA Owner 505-617-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-05-12 |