| NPI | 1902072697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT POEL Executive Director 505-620-3849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NM 86879375) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |