| NPI | 1790791697 |
|---|---|
| Doing Business As | VISTA TAOS RENEWAL CENTER |
| Entity Type | Organization |
| Authorized Contact | BLAKE BROWDER President 575-758-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NM 5633) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-05-02 |