Active NPI
Marillac Clinic, Inc.
- Federally Qualified Health Center (FQHC)
- Grand Junction, CO
National Provider Identifier
1770496770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- MARILLAC CLINIC, INC.
- Practice address
- 455A N 22ND St RM 1
Grand Junction, CO 81501-7907 - Phone
- (970) 200-1600
- Fax
- (970) 692-8301
- NPI assigned
- Sep 23, 2026
- Last updated
- Sep 23, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lata Ramachandran
- Title
- Ceo
- Phone
- (970) 200-1600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
455A N 22ND St RM 1
Grand Junction, CO 81501-7907
Mailing address
526 29 1/2 Rd
Grand Junction, CO 81504-5383
Phone (970) 200-1600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790121600000",
"number": "1770496770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 29 1/2 RD",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815045383",
"telephone_number": "970-200-1600",
"fax_number": "970-692-8301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455A N 22ND ST RM 1",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815017907",
"telephone_number": "970-200-1600",
"fax_number": "970-692-8301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARILLAC CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A",
"authorized_official_last_name": "RAMACHANDRAN",
"authorized_official_first_name": "LATA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "970-200-1600"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
- Andrea Marchese, PT, DPT
- Joanne P Marcotte, CST/CFA
- Mardy Ross, Otr, Registered Occupational Therapist, LLC
- Marillac Clinic, Inc Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc. Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc. Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc. Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc. Dba Primehealth (PrimeHealthplus)
- Marillac Clinic, Inc. Dba Primehealth (Marillac Health Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.