| NPI | 1750370847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE ANN DOZZO Clinical Director 505-296-3965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NM CU00006637) |
| Additional Taxonomies | 251S00000X (Licence: NM CU00006637) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-07-22 |