| NPI | 1760824106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN THOMAS Co Owner 575-224-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 000001147) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2013-07-26 |