| NPI | 1760421168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MARION PENN Owner 505-892-3639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NM R14768) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2012-08-10 |