| NPI | 1710398821 |
|---|---|
| Former Legal Business Name | LACEY STEWART, LLC |
| Entity Type | Organization |
| Authorized Contact | LACEY STEWART Owner 505-440-7169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0187211) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2022-10-17 |