| NPI | 1902918055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GREVING CFO 505-242-4399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NM 3131) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-04-29 |