| NPI | 1194172650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROLA SILKE LOOS Behavioral Health Therapist 505-720-3451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM C-09394) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-05-15 |
| Last Update Date | 2016-05-15 |