| NPI | 1043461163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MASCIATRA CEO 505-272-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: NM R45196) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |