| NPI | 1205809944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGIL MEDINA Chief Executive Officer 575-526-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2022-08-22 |