EL CENTRO FAMILY HEALTH; NPI #1932407681

Contact Information

EL CENTRO FAMILY HEALTH

1331 GUSDORF RD
TAOS, NM 87571-6282

Phone: 575-758-3601
Fax: 575-758-1058
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for EL CENTRO FAMILY HEALTH

NPI # 1932407681

LBN Legal business name EL CENTRO FAMILY HEALTH

Authorized official LORE PEASE - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/04/2011

Last updated 11/21/2014 - About 12 years ago

Identifiers

NM	License #	3385
NM	Medicaid	95534377
NM	Other	1780689034	ORGANIZATION NPPES

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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