| NPI | 1891245189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE PROVENCIO CFO 575-526-6682 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |