| NPI | 1740054352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB MAYBERRY Registered Agent/Treasure 575-746-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2024-06-06 |