| NPI | 1144778671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE Z PORTER Lamft 505-453-6235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM T-0182791) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |