Organization
CLINICA CAMPESINA FAMILY HEALTH SERVICES
Active
Other names
Clinica Family Health & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN J JOHNSTON (CFO)
(303) 926-0625
Entity
Organization
Contact information
Practice address
1735 S PUBLIC RD STE 100, LAFAYETTE, CO 80026-7093
(303) 665-9310
(303) 926-0363
Mailing address
1735 S PUBLIC RD STE 203, LAFAYETTE, CO 80026-7093
(303) 665-3036
(303) 665-9566
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
0556
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638259
—
CO
Enumeration date
10/04/2005
Last updated
10/31/2024
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