| |
6401 S Richards Ave Santa Fe NM 87508-4887 | |
(505) 984-5048 | |
(505) 983-4751 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 6401 S Richards Ave, Santa Fe, New Mexico |
Authorized Official Name and Position | Brandon Vanessa Van Pelt (CEO) |
Authorized Official Contact | 5054245683 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 5395 Santa Fe NM 87502-5395 Ph: (505) 982-4425 | 6401 S Richards Ave Santa Fe NM 87508-4887 Ph: (505) 984-5048 |
NPI Number | 1336437672 |
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Provider Enumeration Date | 07/20/2011 |
Last Update Date | 01/13/2025 |
Identifier | Type | State | Issuer |
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1336437672 | NPI | - | NPPES |
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