NPI | 1083687115 |
---|---|
Doing Business As | LA CLINICA DE FAMILIA SANTA TERESA SCHOOL BASE |
Entity Type | Organization |
Authorized Contact | VIRGIL MEDINA Chief Executive Officer 575-526-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2006-02-09 |
Last Update Date | 2021-05-13 |