| NPI | 1013190610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE K. KAUEMAN Robert. F. Kennedy Sbhc COO Rdinator 505-239-7589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 291U00000X Clinical Medical Laboratory (Licence: NM 3201078041) | |
| 3336C0002X Pharmacy Clinic Pharmacy (Licence: NM CL00D110644) | |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2010-03-04 |