| NPI | 1871538694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA LORANE CARRASCO Administrator 505-999-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NM 6712) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2010-12-13 |