| NPI | 1457687816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JACOBS Director 505-379-0810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0065602) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |