| NPI | 1093965873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DALLAS BROACH Director 505-468-1553 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2009-06-24 |