| Organization Name: | EL CENTRO FAMILY HEALTH |
| NPI Number: | 1164782462 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORE PEASE (CEO) |
| Mailing Address: | 15136 St. Rd. Penasco |
| State: | NM US |
| Postal Code: | 875530000 |
| Phone Number: | 5755872809 |
| Fax Number: | 5755872605 |
| NPI Enumeration Date: | 05/21/2012 |
| NPI Last Update Date: | 11/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |