| NPI | 1407222581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE MACAWILE Director 505-620-0469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM C-08910) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2017-05-09 |