| NPI | 1811167141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN BUCK Sole Proprietor 505-506-5831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0075491) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |