| NPI | 1568123479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD VAGLIO Owner 505-280-5834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2024-05-30 |