| NPI | 1043556897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM PAGE EUBANK Licensed Prof Clinical Counselor 505-327-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0095601) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM 0095591) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |