| NPI | 1912144890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE KAY KAUFMAN Sbhc Coordinator 505-923-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM 104100000X) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM 101Y00000X) |
| 251S00000X Community/Behavioral Health (Licence: NM 251S00000x) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |