| NPI | 1821210501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE ROSE GURULE Contracts Manager 505-710-9210 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-05-04 |