| Organization Name: | DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER |
| NPI Number: | 1548597743 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLENE HAMILTON (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 12000 Stone Lake Road Jicarilla Service Unit Dulce |
| State: | NM US |
| Postal Code: | 87528 |
| Phone Number: | 5757593291 |
| Fax Number: | 5757593532 |
| NPI Enumeration Date: | 11/09/2009 |
| NPI Last Update Date: | 11/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP0904X |
| License Number: | 18451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Public Health, Federal |
| Taxonomy Definition: | |