| NPI | 1760049407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNESSA MARIE VALDEZ SIMPKINS Managing Member/Bh Provider 505-658-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |