| NPI | 1578163481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP TATORIS Owner 505-400-6163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |