| NPI | 1124101365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIAN HOUFEK President & C.E.O. 575-762-3718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-08-23 |