| NPI | 1780059469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE VANARSDALE-IMANI Owner 505-896-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM MD2004-0550) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2021-04-15 |