| NPI | 1922455609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA KATHRYN HAWTHORNE CEO 505-427-1621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM 5211247) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 5211247) |
| 101YM0800X Counselor, Mental Health (Licence: NM 5211247) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |