| NPI | 1891161949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PATRICK VELARDE Assistant Director 505-327-0293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 15-00002011) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2020-10-09 |