| NPI | 1871033167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN MENDOZA Ladac, Owner 575-915-8367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |