| NPI | 1164119921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA KOCH Owner 505-585-5301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-09-27 |