Jicarilla Health Care Facility
Organization Active NPI Community Health Clinic/Center · Dulce, NM
NPI 1003820069 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1003820069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- Legal business name
- JICARILLA HEALTH CARE FACILITY
- Practice address
- 12000 Stone Lake Rd
Dulce, NM 87528 - Phone
- (505) 759-7286
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Thomas T Pryor, RN
- Title
- Public Health Nurse
- Phone
- (505) 759-7286
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | OR | Yes |
Addresses
Primary practice location
12000 Stone Lake Rd
Dulce, NM 87528
Mailing address
PO Box 1144
Pagosa Springs, CO 81147-1144
Other providers in Dulce, NM
- Deanna S Iovine
- Jicarilla Apache Health Care Facility
- Jicarilla Apache Nation
- Jicarilla Apache Nation
- Jicarilla EMS
- Jicarilla IHS Pharmacy
- Ray Morris Joe
- Joan E Kandel
- Karen Keating
- Michael Shawn Kennedy
All providers in Dulce, NM · Community Health Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.