| NPI | 1881856573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM D DUTREMAINE Owner 505-564-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM I-06585) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0090031) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |