LA CLINICA DE FAMILIA, INCORPORATED (NPI# 1164802310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164802310 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE FAMILIA, INCORPORATED |
| Other Organization Name | LAS CRUCES BH ACT |
| Practice Address |
105 W Griggs Ave Las Cruces NM 88001 |
| Mailing Address |
385 Calle De Alegra Bldg. A Las Cruces NM 88005-3423 |
| Practice Telephone | 5756472878 |
| Practice Fax Number | 5755244266 |
| Mailing Telephone | 5755261105 |
| Mailing Fax Number | 5755244266 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2018-05-23 |
| 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 | MEDICARE | 2370905 | 01 |
| NM | 75035774 | 05 |
| Other Name | Type Code |
|---|---|
| Las Cruces BH ACT | 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 |
| 1073993200 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1639559891 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 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 |
105 W GRIGGS AVE |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235162934 | Sharon A. Paulowsky | Counselor | 105 W Griggs Ave, Las Cruces, NM 88001 | 2006-07-08 |
| 1205443777 | Manuela Antonia Corral | Case Manager/Care Coordinator | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-09-28 |
| 1164033239 | Sonya Annette Hicks | Social Worker | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-08-12 |
| 1114536984 | Heather Rose Quiroz | Social Worker | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-07-28 |
| 1750908877 | Paula Rae Barnoskie | Case Manager/Care Coordinator | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-07-06 |
| 1245853266 | Celia Elizabeth Perez | Case Manager/Care Coordinator | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-05-26 |
| 1982237194 | Patricia Ulloa | Case Manager/Care Coordinator | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-02-16 |
| 1699307215 | Michelle Edith Rivera | Licensed Practical Nurse | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-02-11 |
| 1992337745 | Otis Henderson | Case Manager/Care Coordinator | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-02-10 |
| 1922630755 | Katana Wolf | Peer Specialist | 105 W Griggs Ave, Las Cruces, NM 88001-1235 | 2020-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020044 | Three Crosses Regional Hospital LLC | General Acute Care Hospital | 2560 Samaritan Drive, Las Cruces, NM 88001 | 2019-12-17 |
| 1760961908 | Halcyon Health of The Southwest, LLC | Nurse Practitioner | 1355 California Ave Ste B, Las Cruces, NM 88001 | 2018-08-08 |
| 1255818530 | Lago Claro, LLC | Counselor | 2410 S. Espina St, Las Cruces, NM 88001 | 2018-07-19 |
| 1407371818 | Elijah Daniel Perez | Behavior Technician | 1535 Myrtle Ave, Las Cruces, NM 88001 | 2017-08-07 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1457886913 | Mathew Petersen Dds PC | Dentist | 2001 E. Lohman Ave. Suite 121, Las Cruces, NM 88001 | 2017-04-21 |
| 1801343439 | Celia Holmes | Registered Nurse | 505 S Main, Ste 249, Las Cruces, NM 88001 | 2016-09-01 |
| 1427420223 | Sara Guidetti | Family Medicine | 3080 Breland Drive, Las Cruces, NM 88001 | 2015-10-20 |
| 1679987234 | Maria De Jesus Martinez | Nurse Practitioner | 1170 N. Solano Ste A, Las Cruces, NM 88001 | 2014-06-11 |
| 1851701494 | Viola E Garcia | Case Manager/Care Coordinator | 100 W Griggs, Las Cruces, NM 88001 | 2014-05-05 |
| Find all providers in zip 88001 | ||||
| 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 |
| 1073993200 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 2015-06-03 |
| 1639559891 | La Clinica De Familia, Incorporated | Clinic/Center | 575 S Alameda Blvd, Las Cruces, NM 88005-2818 | 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 | 88001 |
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.