| NPI | 1487166880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN LICHTLE Owner 505-588-8207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NM PA-1478) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2018-03-31 |