| NPI | 1205331121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR TORRES Chief Operating Officer 575-520-2230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 0057C) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2018-05-15 |