NPI | 1023186707 |
---|---|
Doing Business As | OJO ENCINO NAVAJO CLINIC |
Entity Type | Organization |
Authorized Contact | DOUG SMITH Executive Vice President 505-992-5565 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NM 1023186707) |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: NM CL00007174) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2021-01-09 |