| NPI | 1801186069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY FRANCES BACA Program Director 505-315-7397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0983) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |