| NPI | 1376118802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CAROLINA FAIT Owner 505-219-1421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-05-26 |