| NPI | 1578995676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISA SCHLEUSENER Credentialing Specialist 505-847-5422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 5382) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2025-02-06 |