| NPI | 1285278242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE MILLER Owner 505-331-0369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2019-11-03 |