| NPI | 1669853339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON A LAMOREE-LUKASAVAGE Office Clinician 505-891-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM i 2081) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |