Organization
LA CLINICA DE FAMILIA, INCORPORATED
Active
Other names
LCDF Community Mental Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGIL MEDINA (CEO)
(575) 526-1105
Entity
Organization
Contact information
Practice address
760 N MOTEL BLVD, LAS CRUCES, NM 88007-4169
(575) 647-2878
(575) 524-4266
Mailing address
385 CALLE DE ALEGRA, BLDG. 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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2370905
MEDICARE
NM
05
—
75035774
—
NM
Enumeration date
06/03/2015
Last updated
09/07/2021
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