| NPI | 1336821354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBROSE BAROS Director Of Operations 505-927-1024 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |