| NPI | 1134450364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL B. MARTINEZ Owner 575-623-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-07156) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-03-09 |