| NPI | 1780491407 |
|---|---|
| Other Name | FOUR CORNERS DETOX RECOVERY CENTER IOP |
| Entity Type | Organization |
| Authorized Contact | ELISA SCHLEUSENER Credentialing Manager 505-847-5422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-06-20 |