| NPI | 1225357981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L SANDOVAL Director Of Contracting 505-727-0019 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2010-05-20 |