Project Vida Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

PROJECT VIDA HEALTH CENTER

Doing business as

Eastlake High School

Practice address

13000 Emerald Pass Ave
El Paso, TX 79928

Phone

(915) 533-7057

Fax

(915) 857-8971

NPI assigned

Nov 14, 2017

Last updated

Mar 25, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William David Schlesinger

Title

Ceo

Phone

(915) 533-7057

Specialties & licenses 1

Addresses

Other names 1

• EASTLAKE HIGH SCHOOL Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285147173. Details of each certification follow.

• CCN 451029 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 451029

Legal name

EASTLAKE HIGH SCHOOL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 11, 2018

Last certification

Dec 11, 2018

Ownership / control type

For profit – corporation

Facility address

13000 Emerald Pass Avenue
El Paso, TX 79928

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1285147173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 RIVERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052415",
            "telephone_number": "915-553-7057",
            "fax_number": "915-857-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 EMERALD PASS AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79928",
            "telephone_number": "915-533-7057",
            "fax_number": "915-857-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT VIDA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "SCHLESINGER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "915-533-7057"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTLAKE HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Project Vida Health Center (Guillen Middle School)
• Project Vida Health Center (Col. J. Ensor Middle School Clinic)
• Project Vida Health Center (Andress High School)
• Project Vida Health Center (Project Vida)
• Project Vida Health Center
• Project Vida Health Center (Sun Ridge Middle School)
• Project Vida Health Center (Desert Wind School)
• Project Vida Health Center (Project Vida Health Center-Family Services)
• Project Vida Health Center (Fernandez Health Clinic)
• Project Vida Health Center

• Federally Qualified Health Center (FQHC) in El Paso, TX
• Providers in El Paso, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.