| NPI | 1326145707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JAMES MAESTAS President/Physician 505-455-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NM 000) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-04-16 |