| NPI | 1518010222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE R LEWIS Clinical Director 505-624-1780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NM 4079) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |