NPI 1003820069

Jicarilla Health Care Facility

Organisation Community Health Clinic/Center Dulce, NM

Practice location

Address: 12000 Stone Lake Rd, Dulce, NM 87528
Phone: (505) 759-7286
Mailing address: PO Box 1144, Pagosa Springs, CO 81147-1144

Authorised official

Name: Thomas T Pryor
Title: Public Health Nurse
Phone: (505) 759-7286

Registered specialties

Community Health Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QC1500X

Other Clinic/Center providers in New Mexico →

Registry record

NPI: 1003820069
Entity type: Organization
NPI issued: 27 Jul 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.