| NPI | 1477067734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATTY JE PLUNKETT Owner 505-633-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0183341) |
| Enumeration Date | 2017-11-24 |
| Last Update Date | 2017-11-24 |