| NPI | 1063767945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY TERRELL BRASHEAR Owner 505-850-9419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0095411) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |