| NPI | 1699262428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA GAUMER CARDENAS Owner 505-414-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 183441) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |