| NPI | 1942670328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUNA CEO 915-225-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-11-21 |