| NPI | 1578598181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE J SHANNON Compliance Mgr. 505-753-1160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 2054) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM NA) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-06-18 |