| NPI | 1629384078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENITA FREEMAN Administrator 505-338-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NM 0093331) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |