Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health Rio Arriba Health Commons Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
2010 INDUSTRIAL PARK RD, ESPANOLA, NM 87532-3600
(505) 753-7218
(505) 753-5815
Mailing address
PO BOX 158, 538 N PASEO DE ONATE, ESPANOLA, NM 87532-0158
(505) 753-7395
(505) 753-8373
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6099
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
ORGANIZATION NPPES
NM
05
—
50146
—
NM
Enumeration date
07/22/2008
Last updated
11/25/2014
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