| NPI | 1568693489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG SMITH Chief Financial Officer 505-982-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NM CL00010622) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2021-01-09 |