| NPI | 1245629187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY TURNER Administrator 575-649-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NM 2261) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |