| NPI | 1275174658 |
|---|---|
| Doing Business As | SHADOW ROCK CARE SERVICES |
| Entity Type | Organization |
| Authorized Contact | BRYAN KEITH GANTZ Guardian/Owner 575-312-0120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2024-05-21 |