| NPI | 1184096661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHEAUX HOLLINGSWORTH Owner 505-652-0669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |