NPI | 1366949398 |
---|---|
Entity Type | Organization |
Authorized Contact | TROY DEAN FERNANDEZ Owner 505-320-2183 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-04850) |
Enumeration Date | 2018-04-06 |
Last Update Date | 2018-04-06 |