| NPI | 1144013103 |
|---|---|
| Other Name | LIFEHOUSE VISTA TAOS |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SUSAN ROGGE-ROGERS Executive Administrator 575-302-8304 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-05-23 |