Organization
MARILLAC CLINIC, INC.
Active
Other names
MarillacHealth
Organization subpart
No
Provider details
NPI number
Authorized official
LATA RAMACHANDRAN (CEO)
(970) 200-1629
Entity
Organization
Contact information
Practice address
87 MERCHANT DR, MONTROSE, CO 81401-3015
(970) 200-1600
(970) 200-1611
Mailing address
2333 N 6TH ST, GRAND JUNCTION, CO 81501-2001
(970) 200-1600
(970) 692-8301
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
02/18/2025
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