Clinica Campesina Family Health Services
Clinic/Center, Federally Qualified Health Center (FQHC) in Nederland, CO. Organization (NPI-2).
NPI number1104579481
StatusActive
Last updated in NPPESJan 27, 2022
Details
- NPI
- 1104579481
- Entity type
- Organization (NPI-2)
- Legal business name
- Clinica Campesina Family Health Services
- Organization subpart
- Yes
- Enumeration date
- Jan 27, 2022
- Certification date
- Jan 27, 2022
- Last updated
- Jan 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- Clinica Family Health (Doing Business As)
Practice location
80 Big Springs Dr Ste 102Nederland, CO 80466-8900
Phone 303-650-4460
Mailing address
1735 S Public RdLafayette, CO 80026-7093
Phone 303-926-0625
Authorized official
Brian J Johnston
Cfo
3039260625
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