| NPI | 1548315864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENEVA JEWEL DEARING Health Coordinator 505-627-2808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2011-09-13 |