DE BACA FAMILY PRACTICE CLINIC

FORT SUMNER, NM
NPI1114737483
Doing Business AsDE BACA FAMILY PRACTICE CLINIC/MOBILE UNIT
Entity TypeOrganization
Authorized ContactLISA WALRAVEN
CEO
575-355-2420
Organization Subpart ?Yes
Primary Taxonomy261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)
Enumeration Date2025-01-09
Last Update Date2025-10-14
Business Address
DE BACA FAMILY PRACTICE CLINIC
546 N 10TH STREET
FORT SUMNER, NM 88119
Phone number: 575-355-2414
Mailing Address
DE BACA FAMILY PRACTICE CLINIC
PO BOX 349
FORT SUMNER, NM 88119-0349
Phone number: 575-355-2414
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DE BACA FAMILY PRACTICE CLINIC
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