| NPI | 1285431809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY WASHINGTON Owner 505-463-9283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2025-03-01 |
| Last Update Date | 2025-03-01 |