| NPI | 1689530644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE WEEMS Owner 505-585-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2026-01-02 |
| Last Update Date | 2026-01-02 |