Bernalillo Spartan Wellness Center

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

NPI 1861607400 · NPPES record last updated Feb 11, 2016

Key facts

NPI
1861607400
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
BERNALILLO SPARTAN WELLNESS CENTER
Practice address
148 Spartan Aly
Bernalillo, NM 87004-6298
Phone
(505) 426-2262
Fax
(505) 454-1473
NPI assigned
May 14, 2007
Organization subpart
No

Authorized official

Name
Dr. James Adrian Abreu
Title
Executive Director
Phone
(505) 454-3523

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Northeast Regional Education Cooperative (6 organizations share this tax ID)

Locations

148 Spartan Aly
Bernalillo, NM 87004
Phone (505) 404-5237

Specialties & licenses

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

Addresses

Primary practice location

148 Spartan Aly
Bernalillo, NM 87004-6298

Mailing address

P.O. Box 927
Las Vegas, NM 87701
Phone (505) 426-2262

Other identifiers

IdentifierTypeStateIssuer
H8226MedicaidNM

Other providers in Bernalillo, NM

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

Sources for this page

Verify at the official NPI Registry.