| NPI | 1902831977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ALICE GARAY Executive Director 575-267-3280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NM 321880) |
| Additional Taxonomies | 261Q00000X (Licence: NM 3015) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2010-09-29 |