| NPI | 1205122769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA JOSEPH PAINE Director 505-266-8168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0095841) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2020-06-16 |