| NPI | 1043857147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HERRON Owner 575-835-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-12-08 |
| Last Update Date | 2024-12-20 |