NPI | 1578598181 |
---|---|
Entity Type | Organization |
Authorized Contact | BEN JUAN TAFOYA Executive Director 505-753-2203 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: NM NA) |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 2054) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2020-08-22 |