Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health Truchas Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
COUNTY ROAD 75 HOUSE #60, TRUCHAS, NM 87578-0346
(505) 689-2461
(505) 689-2462
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6250
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
ORGANIZATION NPPES
NM
05
—
46920
—
NM
Enumeration date
07/24/2008
Last updated
11/21/2014
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