| NPI | 1639435027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON EDWARD RABKA Mental Health Therapist 505-306-9522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0076941) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |