Organization
SOUTHWEST CARE CENTER JEFFERSON ALBUQUERQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ADAMS (CEO)
(505) 989-8200
Entity
Organization
Contact information
Practice address
4710 JEFFERSON NE, SUITE A, ALBUQUERQUE, NM 87109
(505) 955-9454
(505) 888-9644
Mailing address
PO BOX 6880, SANTA FE, NM 87502-6880
(505) 955-9454
(505) 989-8131
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55202080
—
NM
Enumeration date
07/30/2015
Last updated
02/07/2023
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