| NPI | 1871034751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNETTE S LOMARQUEZ Administrator/Clinic Director 915-474-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2022-08-03 |