| NPI | 1649937384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON VANESSA VAN PELT Chief Executive Officer 505-982-4425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2025-01-13 |