| NPI | 1821120742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISA L BERNALLY Medical Social Worker 505-327-7606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2019-08-09 |