| NPI | 1437659638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANYCE WALLACE Owner/Director 505-836-3474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-02-15 |