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Organization

LA CLINICA DEL PUEBLO DE RIO ARRIAB

Active
Parent organization
LA CLINICA DEL PUEBLO DE RIO ARRIBA
Other names
Escalante School Base Health Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
LA CLINICA DEL PUEBLO DE RIO ARRIBA
Authorized official
STEPHANIE GORDON (EMR/CREDENTIALING)
(575) 419-2439
Entity
Organization

Contact information

Practice address
U S HWY 84, COUNTY ROAD 0324, #14, TIERRA AMARILLA, NM 87575-0250
(575) 588-7252
(575) 588-9132
Mailing address
PO BOX 250, US HWY 84, COUNTY RD. 0324, #14, TIERRA AMARILLA, NM 87575-0250
(575) 588-7252
(575) 588-9132

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6253
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114908761
KNACKSTEDT, SHIRLEY, CFNP
NM
01
1336177575
SANCHEZ, JOYCE M., LISW, LADAC
NM
Enumeration date
02/04/2009
Last updated
02/19/2026
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