NPIMap

Organization Active NPI

La Casa de Buena Salud Inc

Doing business as La Casa School Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Clovis, NM
National Provider Identifier
1710283155
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA CASA DE BUENA SALUD INC
Doing business as
La Casa School Dental Clinic
Practice address
1121 Maple Street
Clovis, NM 88130
Phone
(575) 356-6695
Fax
(575) 356-5948
NPI assigned
Feb 2, 2011
Last updated
Feb 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Seferino Montano
Title
Ceo
Phone
(575) 356-6695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1121 Maple Street
Clovis, NM 88130

Mailing address

PO Box 843
Portales, NM 88130-0843
Phone (575) 356-6695

Other names 1

  • La Casa School Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Casa de Buena Salud Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1710283155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300843",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 MAPLE STREET",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "88130",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CASA DE BUENA SALUD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "SEFERINO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "575-356-6695"
    },
    "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": "La Casa School Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.