| NPI | 1699242313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SKELTON Owner 505-506-5171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |