| NPI | 1710053293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG NELSON Bureau Chief, Cyfdjjs 505-331-8562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 172V00000X Community Health Worker | |
| 207QA0000X Family Medicine Adolescent Medicine | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 2080A0000X Pediatrics Adolescent Medicine | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2025-07-14 |