| NPI | 1497171185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL N TUCKER President 505-440-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2024-04-19 |