NPI | 1104442698 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHONNIUSS H CHEMWENO CEO 505-389-2279 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
Additional Taxonomies | 251G00000X Hospice Care, Community Based |
251K00000X Public Health or Welfare | |
251X00000X Supports Brokerage | |
261QH0100X Clinic/Center Health Service | |
Enumeration Date | 2020-06-19 |
Last Update Date | 2020-06-19 |