| NPI | 1083861355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISA R MORTENSEN Clinical Services Administrator 505-324-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM I-06083) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |