| NPI | 1184992612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE NAKAI Division Director 575-758-7824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 298) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |