| NPI | 1841493491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY AYDREN MCNEIL Owner 505-203-6164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0103731) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2008-06-19 |