| NPI | 1467795336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SON-STONE CEO 505-262-2481 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-01-04 |