| NPI | 1033230818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE BREANNE DIAZ Administrative Director 505-265-0753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-4453) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2024-11-26 |