| NPI | 1720243173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM S KEENAN Director 505-977-2074 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NM FA0080936) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NM FA0080936) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2008-07-25 |