| NPI | 1265761449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MATTHEW PADILLA Executive Director 575-840-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM C-09926) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2022-10-25 |