| NPI | 1811239338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNA RAND Owner 575-626-9593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0151651) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |