| NPI | 1871045120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL GONZALES Counselor 505-234-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 3659) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |