| NPI | 1427286509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ROSE TROUT Owner 575-521-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-06248) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |