| NPI | 1689271413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE L CASTILLE Clinical Counselor 505-358-8910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |