| NPI | 1457199481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LISA MORTON Owner 505-977-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |