Organization
LA CASA DE BUENA SALUD INC.
Active
Other names
La Casa Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
SEFERINO MONTANO (CEO)
(505) 356-6695
Entity
Organization
Contact information
Practice address
1515 W FIR, PORTALES, NM 88130
(505) 356-6695
(505) 356-5948
Mailing address
PO BOX 843, PORTALES, NM 88130
(505) 356-6695
(505) 356-5948
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
6338
NM
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48033
—
NM
Enumeration date
09/25/2006
Last updated
07/30/2008
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