| NPI | 1154809283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT KIMBALL Owner 575-443-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 1041C0700X Social Worker Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2020-10-27 |