Jicarilla Health Care Facility in Dulce - Community Health
Jicarilla Health Care Facility - NPI 1003820069
Jicarilla Health Care Facility is a Community Health in Dulce, New Mexico. Jicarilla Health Care Facility practices all healthcare services and medical treatments related to Community Health. The NPI Number for Jicarilla Health Care Facility is 1003820069. The last update date is 2020-08-22.
Jicarilla Health Care Facility's current location address is 12000 Stone Lake Rd, Dulce, New Mexico. You can contact this provider via phone number 5057597286. The mailing address for Jicarilla Health Care Facility is 12000 Stone Lake Rd, Dulce, New Mexico. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jicarilla Health Care Facility |
|---|---|
| Address | 12000 Stone Lake Rd, Dulce, New Mexico |
| Phone Number | 5057597286 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PUBLIC HEA |
|---|---|
| Authorized Official Name | Pryor T Thomas |
| Credentials | RN |
| Telephone Number | 5057597286 |
NPI Number Detail
| NPI Number | 1003820069 |
|---|---|
| Provider Enumeration Date | 2006-07-27 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 12000 Stone Lake Rd |
|---|---|
| City | Dulce |
| State | New Mexico (NM) |
| Post Code | 87528 |
| Phone Number | 5057597286 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Health |
|---|---|
| Taxonomy | 261Qc1500X |
|
Definition: Provides primary medical, dental, mental health, social and preventive services tailored to its community. |
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What is the unique identification code assigned to Jicarilla Health Care Facility by the Centers for Medicare & Medicaid Services?
The Jicarilla Health Care Facility has been issued the NPI (National Provider Identifier) 1003820069. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jicarilla Health Care Facility's physical address?
The Jicarilla Health Care Facility is physically located at 12000 Stone Lake Rd, in the city of Dulce, NM, with the postal code 87528.
What is the Jicarilla Health Care Facility's area of specialization and corresponding taxonomy classification?
The Jicarilla Health Care Facility's specialty field is Community Health, and it falls under the taxonomy code 261Qc1500X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1003820069 to Jicarilla Health Care Facility?
The Jicarilla Health Care Facility received its 1003820069 assignment from the Centers for Medicare & Medicaid Services on 2006-07-27.
As of what date were the details related to Jicarilla Health Care Facility most recently updated or revised?
The information pertaining to Jicarilla Health Care Facility, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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