| NPI | 1306323555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN JEAN KAVALOSKI Owner/CEO 505-635-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0197151) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CCMH0197151) |
| 101YM0800X Counselor, Mental Health (Licence: NM CCMH0197151) | |
| 106S00000X Behavior Technician (Licence: NM CCMH0197151) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |