| NPI | 1265291157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA ANN NINO General Manager 505-525-9649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |