| NPI | 1477440576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG NELSON Bureau Chief 505-331-8562 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 163W00000X Registered Nurse | |
| 207P00000X Emergency Medicine | |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-06-20 |