| NPI | 1912316241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LULEY President 505-803-1748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX p1472) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |