| NPI | 1073138244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DANIEL BURGNER Director 505-726-7642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2025-01-17 |