| NPI | 1306175922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG SMITH Executive Vice President 505-982-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2021-01-09 |