| NPI | 1427617612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY NIEC Clinical Mental Health Counselor 505-426-7847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2021-08-27 |