NPI | 1407360761 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURISSA BUSTILLOS Therapist 575-649-4880 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM T-0193001) |
Enumeration Date | 2017-11-24 |
Last Update Date | 2017-11-24 |