| NPI | 1134595010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MAURICE CLAPP Clinical Director 505-927-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 005494) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM 208527) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |