| NPI | 1962569640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE MARIE HOLDEN Administrator 505-722-9411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NM RTC#4372) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NM RTC#4372) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |