| NPI | 1568838795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE BREEDEN CEO/Director 505-800-7092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: NM NM10061M) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2024-08-26 |