| NPI | 1336718287 |
|---|---|
| Doing Business As | EXCELSIOR MENTAL HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | JASON WYATT Owner/Therapist 575-642-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-09-07 |