1801920632 NPI number — CENTRO DE SALUD FAMILIAR LA FE, INC.

Table of content: (NPI 1801920632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801920632 NPI number — CENTRO DE SALUD FAMILIAR LA FE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO DE SALUD FAMILIAR LA FE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801920632
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1314 E. YANDELL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-534-7979
Provider Business Mailing Address Fax Number:
915-534-7601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12101 SOCORRO RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ELIZARIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-851-5519
Provider Business Practice Location Address Fax Number:
915-851-0558
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RODARTE
Authorized Official First Name:
LUCY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
915-534-7979

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 136357405 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 136357414 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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