| NPI | 1205855970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY JEAN PAREDES Licensed Drug/Alcohol Counselor 505-647-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM 4314) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |