Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health Roy SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
375 EAST 6TH STREET, ROY, NM 87743
(575) 485-0019
(575) 485-0020
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2015/16-19
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
NPPES
NM
05
—
58957553
—
NM
Enumeration date
12/01/2011
Last updated
03/22/2016
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