| NPI | 1568982700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA HOMER Manager/ Owner 505-842-8435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-01-29 |