| NPI | 1316977085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LYNN THIESEN CEO 505-299-2521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: NM IT3229) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-07-29 |