| NPI | 1437502135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANDREA ROMERO Owner 505-503-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0172851) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |