| NPI | 1891962510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JAMES REILLY Director/Owner 505-345-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 02-491408-00-8) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |