| NPI | 1396472924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL GERSON Lpcc 505-699-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-18 |