| NPI | 1508395518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A WATSON Member 505-323-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NM 005683) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-07-21 |