Organization
LA CASA DE BUENA SALUD INC
Active
Other names
La Casa Family Health Center-Los Ninos Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
SEFERINO M MONTANO (CEO)
(575) 356-6695
Entity
Organization
Contact information
Practice address
200 W WILSHIRE BLVD, SUITE A, ROSWELL, NM 88201-0627
(575) 623-3255
Mailing address
200 W WILSHIRE BLVD, SUITE A, ROSWELL, NM 88201-0627
(575) 623-3255
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
PENDING
NM
Other
Enumeration date
03/28/2011
Last updated
03/28/2011
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