| NPI | 1972916153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARCHIE GRINE Director/CEO 505-265-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |