| NPI | 1952699654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY LEWIS Director 505-410-9548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0109871) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |