| NPI | 1265935035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY DEMAREY Co Owner 505-903-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NM 1800016775) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2018-03-17 |