| NPI | 1427857457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC NDAHEBA Executive Director 505-353-1153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-11 |