CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC. (NPI# 1578010070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578010070 |
| Entity Type | Organization |
| Organization Name | CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC. |
| Other Organization Name | CBN HEALTH CENTER, INC |
| Practice Address |
129 Medicine Horse Drive Tohajiilee NM 87026 |
| Practice Telephone | 5059082307 |
| Practice Fax Number | 5059082310 |
| Mailing Telephone | 5059082307 |
| Mailing Fax Number | 5059082310 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2017-02-01 |
| Authorized Official Name | MRS. BEVERLY LEWIS (BUSINESS OFFICE) |
| Authorized Official Telephone | 5059082307 |
| Is Organization Subpart | Y |
| Parent Organization Name | CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 91286018 | 05 |
| Other Name | Type Code |
|---|---|
| CBN Health Center, Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316571441 | Canoncito Band of Navajos Health Center, Inc. | Clinic/Center | 129 Medicine Horse Dr, Tohajiilee, NM 87026-3338 | 2020-02-27 |
| Street Address |
129 MEDICINE HORSE DRIVE |
| City | TOHAJIILEE |
| State | NM |
| Zip Code | 87026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518268242 | Alfred B Benalli | Counselor | 129 Medicine Horse Drive, Tohajiilee, NM 87026 | 2010-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841833589 | Davina M Segay | Prevention Professional | 7 Rio San Jose St, Laguna, NM 87026 | 2019-10-25 |
| 1467094029 | Donovan Lucero | Peer Specialist | 7 Rio San Jose Dr, Laguna, NM 87026 | 2019-10-15 |
| 1316589534 | Kenneth Thomas | Counselor | 7 Rio San Jose, Laguna, NM 87026 | 2019-10-09 |
| 1528586435 | Romilly Ortiz | Physician Assistant | 129 Medicine Horse Dr, Canoncito, NM 87026 | 2017-08-31 |
| 1174071534 | Laguna Early Childhood Program | Early Intervention Provider Agency | I40 W 114 Bldg 1125, Laguna, NM 87026 | 2016-09-14 |
| 1629525605 | Canoncito Band of Navajos Health Center, Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Medicine Horse Road, Canoncito, NM 87026 | 2016-09-07 |
| 1144535337 | Lisa Marie King | Counselor | 86 Medicine Horse Dr., 86 Medicine Horse Dr., Canoncito, NM 87026 | 2010-08-11 |
| 1619151651 | Rosi Aragon | Counselor | Tbhs Building, I-40, 26 Mi. W. of Abq, Exit 131, 3 Mi. N., To'hajiilee, NM 87026 | 2007-12-27 |
| 1538343579 | Canoncito Band of Navajo Health Center, Inc | Community/Behavioral Health | 96 Medicine Horse Dr., To'hajiilee, NM 87026 | 2007-12-27 |
| 1992999296 | Ruth Lynne Kelly | Social Worker | I40 W Exit 131 Highway 56 N, Acl Teen Centers To'hajiilee Community School, To'hajiilee, NM 87026 | 2007-08-29 |
| Find all providers in zip 87026 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | TOHAJIILEE |
| Zip Code | 87026 |
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| 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.