| NPI | 1699352815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN FOUST Owner/Clinician 505-492-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2024-05-25 |