| NPI | 1770009524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SON STONE CEO 505-262-2481 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |