| NPI | 1699009399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN LACKEY President 505-438-2696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM I-1419) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |