| NPI | 1497334023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SANDERSON Owner 505-228-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251S00000X | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2021-10-15 |