| NPI | 1164000501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LYNN SCANLON Owner 575-680-6075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |