| NPI | 1164579082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNAH BURKE Exec. Director 505-877-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2011-01-10 |