Organization
EL CENTRO FAMILY HEALTH
Active
Other names
El Centro Family Health RHS SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORE PEASE (CEO)
(505) 753-7218
Entity
Organization
Contact information
Practice address
1236 5TH ST, LAS VEGAS, NM 87701-4337
(505) 454-2737
Mailing address
538 N PASEO DE ONATE, P.O. BOX 158, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
3393
NM
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780689034
NPPES
NM
Enumeration date
09/18/2014
Last updated
06/07/2023
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