Organization
ACOMA-CANONCITO-LAGUNA INDIAN HEALTH CENTER
Active
Other names
Acoma Canoncito Laguna Indian
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELAINE ALLEY (CEO)
(505) 552-5305
Entity
Organization
Contact information
Practice address
80 B VETERANS BLVD, ACOMA, NM 87034
(505) 552-5300
(505) 552-5490
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5490
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320070
RAILROAD MEDICARE
NM
05
—
H3451
—
NM
Enumeration date
11/21/2006
Last updated
03/09/2022
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