| NPI | 1003615170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW SIDOLI Owner 505-504-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-04-28 |