| NPI | 1275812992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON D LEWIS President/Counselor 575-693-8230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0106271) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM I-06845) |
| 251S00000X Community/Behavioral Health (Licence: NM M-07179) | |
| 251S00000X Community/Behavioral Health (Licence: NM 0125231) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-08-11 |