| NPI | 1891027504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMARR D. EDGERSON Owner/Director 505-629-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM PT0106727) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |