| NPI | 1861772972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY GUSTAMANTES Director 505-573-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: NM 2126) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2023-09-06 |