| El Centro Family Health Maxwell Sbhc | |
|
4th & Parque Avenue Maxwell NM 87728-0275 | |
| (575) 375-2389 | |
| (575) 375-2379 |
| Full Name | El Centro Family Health Maxwell Sbhc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4th & Parque Avenue, Maxwell, New Mexico |
| Authorized Official Name and Position | Lore Pease (CEO) |
| Authorized Official Contact | 5057537218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Centro Family Health Maxwell Sbhc 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Maxwell Sbhc 4th & Parque Avenue Maxwell NM 87728-0275 Ph: (575) 375-2389 |
| NPI Number | 1013296425 |
|---|---|
| Provider Enumeration Date | 08/16/2011 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013296425 | NPI | - | NPPES |
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 20920334 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |