| NPI | 1619850955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA LEE Billing Specialist /Contract Coordi 505-397-5172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-31 |