| NPI | 1467691022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN MICHAEL DEMPSEY President 505-848-3773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM 69-126) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-02-05 |