| NPI | 1609089408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MARTINEZ Executive Director 505-747-8187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NM CSOOO2020217) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |