| NPI | 1164257622 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | FELIPITA C JACKS Owner, Chw Sp. 2 505-319-9591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-09 |