NPI | 1528424397 |
---|---|
Doing Business As | LA CLINICA DE FAMILIA CENTRAL MEDICAL |
Entity Type | Organization |
Authorized Contact | VIRGIL MEDINA Chief Executive Officer 575-526-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-01-11 |
Last Update Date | 2021-05-13 |