| NPI | 1396058079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSITA A. MOYA-HERRERA Therapist 505-771-5958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM M-05024) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |