Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health WLS SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
1024 SOUTH PACIFIC, LAS VEGAS, NM 87701
(505) 426-2599
(505) 426-2579
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
02932
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
NPPES
NM
Enumeration date
11/30/2011
Last updated
11/21/2014
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