| NPI | 1992106041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE I SALAZAR Self/Owner 505-603-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 4024) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |