| NPI | 1427567486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLENE BUNCH Owner 505-289-1042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 225X00000X Occupational Therapist | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NM 0185071) | |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2019-04-04 |