| 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 |