LA CLINICA DE FAMILIA, INCORPORATED (NPI# 1073993200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073993200 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE FAMILIA, INCORPORATED |
| Other Organization Name | LAS CRUCES BH PSR |
| Practice Address |
575 S Alameda Blvd Las Cruces NM 88005-2818 |
| Mailing Address |
385 Calle De Alegra Bldg. A Las Cruces NM 88005-3423 |
| Practice Telephone | 5756472817 |
| Practice Fax Number | 5755244266 |
| Mailing Telephone | 5755261105 |
| Mailing Fax Number | 5755244266 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2019-10-14 |
| Authorized Official Name | VIRGIL MEDINA (CEO) |
| Authorized Official Telephone | 5755261105 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 43074286 | 05 | |
| NM | MEDICARE | 2370905 | 01 |
| Other Name | Type Code |
|---|---|
| Las Cruces BH PSR | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902436702 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr Bldg 2, Chaparral, NM 88081-7809 | 2020-01-21 |
| 1508838004 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr, Chaparral, NM 88081-7809 | 2006-02-07 |
| 1730152281 | La Clinica De Familia, Incorporated | Clinic/Center | 2625 Mcnutt Rd, Sunland Park, NM 88063-9019 | 2006-02-07 |
| 1962047506 | La Clinica De Familia, Incorporated | Clinic/Center | 2625 Mcnutt Rd Ste B, Sunland Park, NM 88063-9608 | 2019-11-07 |
| 1255711255 | La Clinica De Familia, Incorporated | Foster Care Agency | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-04 |
| 1033599022 | La Clinica De Familia, Incorporated | Clinic/Center | 826 Anthony Dr., Anthony, NM 88021-9346 | 2015-06-04 |
| 1639559891 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1164802310 | La Clinica De Familia, Incorporated | Clinic/Center | 105 W Griggs Ave, Las Cruces, NM 88001 | 2015-06-03 |
| 1871973297 | La Clinica De Familia, Incorporated | Clinic/Center | 100 W Griggs Ave, Las Cruces, NM 88001-1234 | 2015-06-01 |
| 1003087867 | La Clinica De Familia, Incorporated | Social Worker | 570 W Griggs Ave, Las Cruces, NM 88005-2604 | 2008-03-19 |
| Street Address |
575 S ALAMEDA BLVD |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88005-2818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892385 | Francis Toby Casci | Dentist | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2005-06-21 |
| 1740889153 | Fabiola Garcia | Case Manager/Care Coordinator | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2020-10-19 |
| 1063030393 | Rafael Gonzalez Rascon | Dentist | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2020-07-13 |
| 1497394969 | Sergio Andres Gonzales | Case Manager/Care Coordinator | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2020-01-02 |
| 1013561042 | William Edward Heidenreich | Social Worker | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2019-07-29 |
| 1588216428 | Cynthia Coba | Marriage & Family Therapist | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2019-07-11 |
| 1043862170 | Victoria Compean | Social Worker | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2019-07-09 |
| 1538632922 | Caitlin Eileen Talty | Social Worker | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2019-01-08 |
| 1871091876 | Annette Michelle Golucke | Nurse Practitioner | 575 S Alameda Blvd, Las Cruces, NM 88005 | 2018-01-25 |
| 1609397322 | Elizabeth C Solorzano | Technician, Other | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2017-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871158345 | Raymond Pope Stewart Jr. | Community Health Worker | 9999 W. Amador Avenue, Ste. A, Las Cruces, NM 88005 | 2019-05-09 |
| 1538638481 | Jennifer Mcafee | Social Worker | 3100 Oak St. Las Cruces, Nm, Las Cruces, NM 88005 | 2018-11-21 |
| 1023583226 | Richard Flores | Physical Therapist | 1090 Med Park Dr., Las Cruces, NM 88005 | 2018-10-04 |
| 1558850834 | Connections Therapy, Inc. | Counselor | 225 E Idaho Ave Ste 25, Las Cruces, NM 88005 | 2018-05-02 |
| 1982134771 | Madalyn Elyse Sprague | Behavior Technician | 1007 Ellendale Dr, Las Cruces, NM 88005 | 2017-06-14 |
| 1043766249 | Leandra Gabrielle Abeyta | Registered Nurse | 2363 W University Ave, Las Cruces, NM 88005 | 2016-08-28 |
| 1790172641 | Amistad Milestones LLC | Speech-Language Pathologist | 3100 Oak Street, Las Cruces, NM 88005 | 2015-04-17 |
| 1043628753 | Richael Anne Bouvet-jenkins | Social Worker | 755 W. Hadley Avenue, Las Cruces, NM 88005 | 2014-07-25 |
| 1194133801 | Helena Catalina Melendez | Dental Hygienist | 385 Calle Alegra Blg C, Las Cruces, NM 88005 | 2014-07-25 |
| 1447668256 | Cherie O'dell | Specialist | 1758 Highland Ave, Las Cruces, NM 88005 | 2014-07-24 |
| Find all providers in zip 88005 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487026563 | Ben Archer Health Center | Clinic/Center | 3331 Del Rey Blvd., Las Cruces, NM 88012 | 2015-10-28 |
| 1639553928 | La Clinica De Familia, Inc. | Clinic/Center | 1950 Sonoma Ranch Blvd., Las Cruces, NM 88011 | 2015-07-16 |
| 1427330513 | Ben Archer Health Center | Clinic/Center | 1998 Motel Blvd, Las Cruces, NM 88007 | 2011-09-14 |
| 1285141549 | St. Luke's Health Care Clinic, Inc. | Clinic/Center | 999 W Amador Ave, Las Cruces, NM 88005-2739 | 2018-01-08 |
| 1528424397 | La Clinica De Familia, Inc. | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2016-01-11 |
| 1639559891 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1164802310 | La Clinica De Familia, Incorporated | Clinic/Center | 105 W Griggs Ave, Las Cruces, NM 88001 | 2015-06-03 |
| 1871973297 | La Clinica De Familia, Incorporated | Clinic/Center | 100 W Griggs Ave, Las Cruces, NM 88001-1234 | 2015-06-01 |
| 1699105320 | Ben Archer Health Center | Clinic/Center | 1955 N Valley Dr, Las Cruces, NM 88007-5154 | 2013-11-15 |
| 1205809944 | La Clinica De Familia, Inc. | Clinic/Center | 385 Calle De Alegra, Bldg. B, Las Cruces, NM 88005-3423 | 2006-02-13 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88005 |
Please comment or provide details below to improve the information on LA CLINICA DE FAMILIA, INCORPORATED.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.