| NPI | 1740691328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN HEIDEN Clinical Director 505-983-0586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 1629128046) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-16 |