| NPI | 1598000721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK WILSON Clinical Director 505-508-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NM 1035) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-11-28 |