| NPI | 1730902164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALIA MEDINA BUSTILLOS Owner 505-267-7031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-04 |