| NPI | 1952774796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ADAMS CEO 505-989-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NM 1300029059) |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2021-09-30 |