El Centro Family Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Maxwell, NM
NPI 1013296425 · NPPES record last updated Nov 20, 2015
Key facts
- NPI
- 1013296425
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- EL CENTRO FAMILY HEALTH
- Practice address
- 4TH & Parque Avenue
Maxwell, NM 87728-0275 - Phone
- (575) 375-2389
- Fax
- (575) 375-2379
- NPI assigned
- Aug 16, 2011
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lore Pease
- Title
- Ceo
- Phone
- (505) 753-7218
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
4TH & Parque Avenue
Maxwell, NM 87728-0275
Mailing address
538 N Paseo de Onate
P.O. Box 158
Espanola, NM 87532-2618
Phone (505) 753-7218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 20920334 | Medicaid | NM |
Other names
- El Centro Family Health Maxwell SBHC
Other providers in Maxwell, NM
All providers in Maxwell, NM · Federally Qualified Health Center (FQHC) 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 Nov 20, 2015. 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.