NPI | 1619269446 |
---|---|
Entity Type | Organization |
Authorized Contact | REGINALD ANTHONY GIBBS Pastor/Director 575-915-0450 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2011-05-12 |
Last Update Date | 2011-05-12 |