| NPI | 1457789125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY K BACA Owner 505-795-5217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2008-0553) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |