Organization
EL CENTRO FAMILY HEALTH
Active
Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health MMS SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
947 OLD NATIONAL ROAD, LAS VEGAS, NM 87701
(505) 454-2794
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 853-5815
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3394
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
NPPES
NM
Enumeration date
09/17/2014
Last updated
03/22/2016
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