| NPI | 1841480902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUNA Chief Executive Officer 915-225-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2014-04-30 |