| NPI | 1558668434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE CHAVEZ Billing Specialist 505-852-1977 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM M-07620) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2011-04-19 |