| NPI | 1629495296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CLAY PEARSON Director 505-879-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM LPCC LADAC) |
| Additional Taxonomies | 251B00000X Case Management (Licence: NM LPCC LADAC) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2016-06-03 |