| NPI | 1417440777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA SANDOVAL CEO 575-581-4728 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |