| NPI | 1558603423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS MCVICKAR DOLE Owner/Counselor 505-888-7033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0122281) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |