| NPI | 1598069338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JACKSON Executive Director 505-268-5295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NM I05341) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |