NPI | 1134917040 |
---|---|
Doing Business As | MAYFIELD HIGH SCHOOL BASE |
Entity Type | Organization |
Authorized Contact | VIRGIL MEDINA CEO 575-526-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2025-04-29 |
Last Update Date | 2025-04-29 |