| NPI | 1699105320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY KOENIG Financial Officer 575-267-3280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |