| Organization Name: | EL CENTRO FAMILY HEALTH |
| NPI Number: | 1013202969 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUCILLE MONTOYA (CHIEF OPERATIONS OFFICER) |
| Mailing Address: | 620 N. Coronado Street Espanola |
| State: | NM US |
| Postal Code: | 875320158 |
| Phone Number: | 5057537218 |
| Fax Number: | 5057535815 |
| NPI Enumeration Date: | 06/17/2011 |
| NPI Last Update Date: | 06/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP-01740 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |