| NPI | 1558576165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MARK BACA Director 505-872-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 89-5) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |