| NPI | 1962074484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALITA G MALONEY Clinical Supervisor 505-792-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |