| NPI | 1023225778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA SISNEROS Statewide Clinic Coordinator 505-476-8863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |