NPI | 1073949376 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDY L SAMANIEGO Owner 505-967-9975 |
Organization Subpart ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-07362) |
Enumeration Date | 2013-09-18 |
Last Update Date | 2013-09-18 |