| NPI | 1407311749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS SANFILIPO Owner 505-435-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2020-01-30 |