JICARILLA HEALTH CARE FACILITY – NPI #1003820069
Clinic/Center

JICARILLA HEALTH CARE FACILITY is an AHC clinic located in DULCE, NM. NPPES has assigned the NPI number 1003820069 to JICARILLA HEALTH CARE FACILITY on July 27, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QC1500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Community Health

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JICARILLA HEALTH CARE FACILITY below.

NPI Profile for
JICARILLA HEALTH CARE FACILITY

NPI Number
1003820069
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JICARILLA HEALTH CARE FACILITY
Primary location
12000 STONE LAKE RD
DULCE, NM 87528
Phone: (505) 759-7286 Fax:
Mailing address
PO BOX 1144
PAGOSA SPRINGS, CO 81147-1144
Phone: Fax:
Organization Subpart
No
Authorized Official
THOMAS PRYOR
PUBLIC HEALTH NURSE
Phone: (505) 759-7286
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QC1500X
- Clinic/Center / Community Health (Primary)		 OR

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.