| NPI | 1386037364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL L. PARKER Sole Proprietor 505-235-1284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 4775) |
| Enumeration Date | 2015-03-14 |
| Last Update Date | 2015-03-14 |