| NPI | 1851524623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALDO WINBORN Therapist 575-494-1677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0116391) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |