| NPI | 1215481239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELINA T BACA Counselor 505-263-4159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM T-0181961) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |