| NPI | 1700945367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK QUEVEDO Executive Director 505-326-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2019-07-23 |