| NPI | 1437554961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GATELY Owner 505-414-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 03303958005) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-29 |