NPI | 1083150379 |
---|---|
Entity Type | Organization |
Authorized Contact | YAUNCAY J LUCAS CFO/CEO 505-814-9745 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 2002981062101) |
Enumeration Date | 2017-01-11 |
Last Update Date | 2017-01-11 |