| NPI | 1902359615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANN WOLFF President/Provider 505-507-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-08546) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0179961) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2019-06-20 |