DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER; NPI #1548597743

Contact Information

DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER

12000 STONE LAKE ROAD
JICARILLA SERVICE UNIT
DULCE, NM 87528

Phone: 575-759-3291
Fax: 575-759-3532
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Public Health, Federal	261QP0904X

Indicates primary specialty

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NPI Profile & details for DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER

NPI # 1548597743

LBN Legal business name DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER

Authorized official CHARLENE HAMILTON - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/09/2009

Last updated 11/09/2009 - About 17 years ago

Identifiers

CO	License #	18451
NM	Medicaid	000K3526
NM	Other	HSZ196	MEDICARE PART B

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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