| NPI | 1881837912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON B DELUISA Owner 505-331-0295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM CNP-01518) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2010-02-17 |