NPIMap

Organization Active NPI

La Casa de Buena Salud Inc.

  • Federally Qualified Health Center (FQHC)
  • Portales, NM
National Provider Identifier
1972603165
Registry record updated Jul 30, 2008
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.
Practice address
1515 W Fir
Portales, NM 88130
Phone
(505) 356-6695
Fax
(505) 356-5948
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Seferino Montano
Title
Ceo
Phone
(505) 356-6695

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 6338 NM
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1515 W Fir
Portales, NM 88130

Mailing address

PO Box 843
Portales, NM 88130
Phone (505) 356-6695

Other identifiers 1

IdentifierTypeStateIssuer
48033MedicaidNM

Other names 1

  • La Casa Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129001141 NM Part B Supplier - Clinic/Group Practice 9234032939 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Portales, NM
O20081224000288 NM Part A Provider - Federally Qualified Health Center (FQHC) 9234032939 Practice locations: Portales, NM

Federally qualified health center certification: CCN 321802

Legal name
LA CASA DE BUENA SALUD INC
Doing business as
LA CASA FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1974 in NM
Enrollment address
1515W Fir St
Portales, NM 88130-5703

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
La Casa de Buena Salud Inc15 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

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joe Strickland Individual Corporate DirectorBoard Member Jan 1, 2016
Margaret Tarango Individual Corporate DirectorBoard Member Jan 1, 2023
Isabell Walla Individual Corporate Director Dec 2, 2008
Veronica Apodaca Individual Corporate DirectorBoard Member Jan 26, 2022
Lisa Jaynes Individual Corporate DirectorBoard Member Jan 23, 2019
Katherine McClain Individual Corporate DirectorBoard Member Jan 26, 2022
Carmen Pacheco-Munoz Individual W-2 Managing EmployeeAd; May 27, 2026
Desiree Smith Individual Corporate DirectorBoard Member Jan 1, 2025
Veronica Cordova Individual Corporate DirectorBoard Member Jan 23, 2019
Warren a Yehl Individual Corporate DirectorBoard Member Jan 26, 2022

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1972603165",
    "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": "88130",
            "telephone_number": "505-356-6695",
            "fax_number": "505-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W FIR",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "88130",
            "telephone_number": "505-356-6695",
            "fax_number": "505-356-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CASA DE BUENA SALUD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "SEFERINO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-356-6695"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NM",
            "license": "6338",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48033",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Casa Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portales, NM

Sources for this page

Verify at the official NPI Registry.