El Centro Family Health

Organization Active NPI Federally Qualified Health Center (FQHC) · Roy, NM

NPI 1225306525 · NPPES record last updated Mar 22, 2016

Key facts

NPI
1225306525
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
2015/16-19 (NM)
Legal business name
EL CENTRO FAMILY HEALTH
Practice address
375 East 6TH Street
Roy, NM 87743
Phone
(575) 485-0019
Fax
(575) 485-0020
NPI assigned
Dec 1, 2011
Organization subpart
No

Authorized official

Name
Mrs. Lore Pease
Title
Ceo
Phone
(505) 753-7218

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2015/16-19 NM Yes

Addresses

Primary practice location

375 East 6TH Street
Roy, NM 87743

Mailing address

538 N Paseo de Onate
P.O. Box 158
Espanola, NM 87532-2618
Phone (505) 753-7218

Other identifiers

IdentifierTypeStateIssuer
1780689034OtherNMNPPES
58957553MedicaidNM

Other names

  • El Centro Family Health Roy SBHC Other name

Other providers in Roy, NM

All providers in Roy, NM · Federally Qualified Health Center (FQHC) in New Mexico

Sources for this page

Verify at the official NPI Registry.