| NPI | 1144315615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER METZLER Executive Director 505-766-5197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NM 6783) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: NM CL00007301) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-01-08 |