| NPI | 1407562622 |
|---|---|
| Doing Business As | LCDF PICACHO SCHOOL BASE |
| Entity Type | Organization |
| Authorized Contact | VIRGIL MEDINA CEO 575-526-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-01-31 |