| NPI | 1730736505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNI AMSDEN Mental Health Provider 505-280-3089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-12-11 |