| NPI | 1326775628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD TEBOH MBATANG Owner 575-650-7354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2024-08-08 |