| NPI | 1447265160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISA SCHLEUSENER Credentialing Manager 505-847-5422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 5382) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-06-20 |