| NPI | 1770970972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CALLAWAY Owner 505-913-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 15-00131354) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-04-25 |