La Casa De Buena Salud INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Clovis, NM. Organization (NPI-2).
NPI number1730485244
StatusActive
Last updated in NPPESJan 31, 2011
Details
- NPI
- 1730485244
- Entity type
- Organization (NPI-2)
- Legal business name
- La Casa De Buena Salud INC
- Organization subpart
- No
- Enumeration date
- Jan 31, 2011
- Last updated
- Jan 31, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- La Casa Dental School Clinic (Doing Business As)
Practice location
400 Lockwood DriveClovis, NM 88101-8445
Phone 575-769-5021 · Fax 575-763-9154
Mailing address
Po Box 843Portales, NM 88130-0843
Phone 575-356-6695 · Fax 575-356-5948
Authorized official
Seferino Montano
Ceo
5753566695
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All 7 Federally Qualified Health Center (FQHC) providers in Clovis · All 1,421 providers in Clovis
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