| NPI | 1992352942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISAANN TORREZ Owner, Credentialing Specialist 575-770-8136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |