| NPI | 1568976942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JEFFERSON BOSTON Executive Director 505-710-6530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2025-01-10 |