| NPI | 1023314127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY ALLISON BOX Clinical Director 505-363-2492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-07102) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-02-07 |