| NPI | 1831584192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIL VIGIL Executive Director 505-231-5469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |