| NPI | 1649954660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ORAVEC Owner/Provider 575-649-1865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-07-05 |