| NPI | 1780129866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNNY A LAURENNE Owner 505-977-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0159491) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |