| NPI | 1689228579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA RUE Co Owner 505-317-3792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2020-02-07 |