| NPI | 1043376288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK L. HUMPHRIES President 505-620-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM I-3613) |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2020-08-22 |