| NPI | 1699221366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINE LOPEZ-BOWERS Owner 505-796-2095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0152101) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |