| NPI | 1902164585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE ANDERSON Treatment Team Leader 505-268-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NM R24768) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |