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NPI Code Detail

MEDICARE: CLINICA CAMPESINA FAMILY HEALTH SERVICES

MEDICARE: CLINICA CAMPESINA FAMILY HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689411654
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA CAMPESINA FAMILY HEALTH SERVICES
Provider Business Mailing Address
First Line : 1455 DIXON AVE
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-8879
Country : US
Telephone Number : 303-443-8500
Fax Number : 720-687-2752
Provider Business Practice Location Address
First Line : 1107 W CENTURY DR
Second Line :
City : LOUISVILLE
State : CO
Zip : 80027-1693
Country : US
Telephone Number : 303-443-8500
Fax Number :
Authorized Official
Title or Position : CFO
Name : BRIAN J JOHNSTON
Credential :
Telephone Number : 303-926-0625
Provider Enumeration Date : 07/09/2024
Last Update Date : 11/10/2025

Similar Medicare Providers

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Practice Location Address:
1107 W CENTURY DR
LOUISVILLE, CO
80027-1693
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1194392993 — PATRICK TIMOTHY LALANCETTE PTA
Practice Location Address:
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1295573954 — CLINICA CAMPESINA FAMILY HEALTH SERVICES
Practice Location Address:
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LOUISVILLE, CO
80027-1693
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Practice Fax: 303-443-8500
1114896826 — ANDREW JAMES BENDER
Practice Location Address:
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80027-1693
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Practice Fax:
1801752639 — KRISTIN MARY DONESKI
Practice Location Address:
1107 W CENTURY DR
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Directions to “CLINICA CAMPESINA FAMILY HEALTH SERVICES ” Practice Location

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