Organization
LA CLINICA DE FAMILIA, INCORPORATED
Active
Other names
LCDF Desert Pride School Base
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGIL MEDINA (CEO)
(575) 526-1105
Entity
Organization
Contact information
Practice address
100 SHRODE RD, ANTHONY, NM 88021-7350
(575) 526-1105
(575) 524-4266
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
05/13/2021
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