NPI | 1861808800 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLEY MARTINEZ Owner/Provider 505-410-1773 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 005695) |
Enumeration Date | 2014-07-10 |
Last Update Date | 2014-07-10 |