| NPI | 1154352532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROOKER Fiscal Officer 575-267-3280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NM 321805) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NM 6316) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2010-10-05 |