| NPI | 1992241293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ZERBST Owner 505-730-6795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0186641) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |