| NPI | 1740716471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY J. VAS Psychologist 575-496-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 0844) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NM 0844) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NM 0844) | |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |