| NPI | 1326445115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSIE MCGUIRE Executive Director 505-315-6308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2019-03-20 |