| NPI | 1922646595 |
|---|---|
| Doing Business As | PSYCHOGENESIS |
| Entity Type | Organization |
| Authorized Contact | JAVIER VERA Owner 505-585-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-12-14 |
| Last Update Date | 2020-04-22 |