Organization
FNCH OUTPATIENT SERVICES
Active
Parent organization
FIRST NATIONS COMMUNITY HEALTH SOURCE, INC.
Other names
FNCH Outpatient Services, FNCH Outpatient Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIRST NATIONS COMMUNITY HEALTH SOURCE, INC.
Authorized official
SUZETTE GUTIERREZ (CREDENTIALING SPECIALIST)
(505) 262-6567
Entity
Organization
Contact information
Practice address
634 MANZANO STREET NE, ALBUQUERQUE, NM 87110
(505) 262-2481
(505) 265-7045
Mailing address
5608 ZUNI RD SE, ALBUQUERQUE, NM 87108-2926
(505) 262-2481
(505) 265-7045
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004-6912
—
NM
Enumeration date
08/03/2017
Last updated
10/08/2024
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