| NPI | 1497872550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN BAKER Co Owner 505-769-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |