| NPI | 1649315102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS MARQUEZ Executive Director 505-323-3785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 600153) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-07-21 |