| NPI | 1912208075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY L ENCINIAS Executive Director 505-242-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 3841) |
| Additional Taxonomies | 251S00000X (Licence: NM 2231) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |