| NPI | 1639496631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DECANDITIS Occupational Therapist 505-615-7016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: NM 1415) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2010-04-29 |