| NPI | 1730426362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HUBERMAN Clinical Supervisor 505-946-1488 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0154641) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |