| NPI | 1932777281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARK MESH Clinical Supervisor 575-770-9651 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |