Organization
BERNALILLO FAMILY HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON B DELUISA CNP (OWNER)
(505) 508-0197
Entity
Organization
Contact information
Practice address
200 OAK ST NE, SUITE 2, ALBUQUERQUE, NM 87106-4740
(505) 508-0187
(505) 508-0465
Mailing address
200 OAK ST NE STE 2, ALBUQUERQUE, NM 87106-5614
(505) 508-0187
(505) 508-0465
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/25/2011
Last updated
08/13/2012
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