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Organization

BERNALILLO SPARTAN WELLNESS CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES ADRIAN ABREU (EXECUTIVE DIRECTOR)
(505) 454-3523
Entity
Organization

Contact information

Practice address
148 SPARTAN ALY, BERNALILLO, NM 87004-6298
(505) 426-2262
(505) 454-1473
Mailing address
P.O. BOX 927, LAS VEGAS, NM 87701
(505) 426-2262
(505) 454-1473

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
H8226
NM
Enumeration date
05/14/2007
Last updated
02/11/2016
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