| NPI | 1063258747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ANDREW ENGLE Owner 505-379-6773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-02 |