| NPI | 1326607169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE TRUJILLO Patient Accounts Supervisor 719-543-8718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |