| NPI | 1043688088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN NNAMDI NWAOGU Administrator 575-382-5973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NM 1T3533) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |