| NPI | 1568109767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA L. KAMINSKI Member 505-227-3094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |