| |
1691 Galisteo St Ste D Santa Fe NM 87505-4781 | |
(505) 954-1921 | |
(505) 983-6520 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1691 Galisteo St Ste D, Santa Fe, New Mexico |
Authorized Official Name and Position | Michael Adams (CEO) |
Authorized Official Contact | 5059898200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 6880 Santa Fe NM 87502-6880 Ph: (505) 395-2288 | 1691 Galisteo St Ste D Santa Fe NM 87505-4781 Ph: (505) 954-1921 |
NPI Number | 1295109072 |
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Provider Enumeration Date | 11/17/2015 |
Last Update Date | 01/16/2025 |
Identifier | Type | State | Issuer |
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1295109072 | NPI | - | NPPES |
1295109072 | Other | NM | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | 1300117376 (New Mexico) | Secondary |
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