| NPI | 1740581511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ANNETTE BROOKS Owner 505-550-9536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0133481) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |