| NPI | 1326570425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SON STONE Chiefr Executive Officer 505-262-6588 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2024-10-08 |