| NPI | 1003623018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELRAY MOISES BLEA SMITH Owner/Director 505-906-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2025-02-22 |