Organization
SOUTHERN UTE INDIAN TRIBE
Active
Organization
SOUTHERN UTE INDIAN TRIBE
Active
Other names
SOUTHERN UTE HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGETTE C MILLER MHA, CHPSE (SUPPORT SERVICE MANAGER)
(970) 563-2459
Entity
Organization
Contact information
Practice address
123 WEEMINUCHE AVE., IGNACIO, CO 81137-0899
(970) 563-4581
(970) 563-0208
Mailing address
PO BOX 899, IGNACIO, CO 81137-0899
(970) 563-4581
(970) 563-4833
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18500323
—
CO
05
—
H0107
—
NM
Enumeration date
06/27/2006
Last updated
05/23/2023
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