| NPI | 1780919456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL MARTINEZ Director 505-753-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 2054) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |