| NPI | 1649431677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MASCIOTRA CEO 505-272-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: NM 88-PA05) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |