Organization
EL CENTRO FAMILY HEALTH
Active
Parent organization
EL CENTRO FAMILY HEALTH
Other names
Sierra Vista School Based Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
EL CENTRO FAMILY HEALTH
Authorized official
HEATHER RECTOR (CREDENTIALING SPECIALIST II)
(505) 747-5946
Entity
Organization
Contact information
Practice address
475 LEGION DR., LAS VEGAS, NM 87701
(505) 425-6788
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 747-7396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
06/07/2023
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