| NPI | 1578644415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REUBEN SUTTER Owner 505-884-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM MD2005-0751) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-11-15 |