| NPI | 1801207105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN RABURN Owner 575-461-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NM 96-388) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |