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Family and friends rushed to the scene when the news broke.
Gunmen have broken into a drug rehab center in central Mexico, killing 24 people.
At least seven others were injured, including three seriously in Wednesday’s attack, according to police.
It is the second attack in a rehabilitation facility in Irapuato, Guanajuato, in a month, and one of the deadliest massacres this year.
The reason is unknown, but gangs often target clinics where they believe members of rival factions are hiding.
The last rehabilitation center that was hit was not officially registered, according to authorities.
The state has hundreds of unofficial treatment centers. The previous attack, at a nearby center called Starting a New Life, killed 10 people.
Police told local media that in the latest ambush, several gunmen jumped out of a truck and rushed to the building, where they forced those present to fall to the ground before shooting them.
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Witnesses said family members rushed to the scene and some women, believed to have children being treated inside, collapsed when the news broke.
President Andrés Manuel López Obrador said it was a “very serious situation”.
He called on the opposition-controlled Guanajuato government to investigate whether the attack could be due in part to a “conspiracy” between local officials and criminal gangs.
Guanajuato’s attorney general, Carlos Zamarripa, called it a “cowardly” attack.
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Soldiers guarded the facilities after the attack.
A territorial war has broken out in Guanajuato, where the local Santa Rosa de Lima gang competes with the brutal Jalisco New Generation Cartel, which has become one of the country’s most dominant organized crime groups.
It is not yet known if either group was involved in the latest attack.
“We have no information on those responsible. There is no data on the vehicles or the people,” police told local media immediately afterward.
However, the state governor, Diego Sinhue Rodríguez Vallejo, said the gangs appeared to have been involved.
“I deeply regret and condemn the events in Irapuato this afternoon,” he wrote on Twitter. “The violence generated by organized crime not only takes the lives of young people, but also takes peace away from families in Guanajuato.”
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The state now has the highest number of homicides in the country, according to the National Public Security System (SNSP).
President Andrés Manuel López Obrador, who came to power in late 2018, promised to crack down on gang violence. However, the national murder rate hit a record high in 2019 and this year has brought some high-profile attacks.
Last week, an assassination attempt was made against a Mexico City police chief.
Omar García Harfuch survived after his car was ambushed, but three others, two bodyguards and a passerby, were killed in the shooting.
A federal judge, Uriel Villegas Ortiz, and his wife, Verónica Barajas, were killed in June.
Both attacks are believed to be linked to the Jalisco New Generation Cartel, but this has not been confirmed as investigations are ongoing.
