| NPI | 1013491638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETTICIA URIOSTE Member 505-570-1927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |