| NPI | 1477893717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN WOODRING Managing Official 505-235-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0129271) |
| Enumeration Date | 2013-02-24 |
| Last Update Date | 2013-02-24 |