| NPI | 1366514861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REVA LEE HERON Executive Director 505-662-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |