| NPI | 1992481741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE SARAH CLINTON Nurse Practitioner 505-555-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2024-07-03 |