| NPI | 1245802677 |
|---|---|
| Doing Business As | PUEBLO CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL THEODORE BERG Corp Officer 505-468-4742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |