| NPI | 1467685644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE EILEEN MERRELL-MCDONALD Program Director 505-332-9424 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-03 |