| NPI | 1609058262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HAROLD BULL President 505-881-8666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NM 7399) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-10 |