| NPI | 1518910553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG SMITH VP Of Finance 505-982-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 1223G0001X Dentist, General Practice | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-01-14 |