| NPI | 1457619934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RAY BLACK M.D. 575-578-4548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NM MD2011-0547) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NM MD2011-0547) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |