Healthcare Provider Details

I. General information

NPI: 1447377924
Provider Name (Legal Business Name): PROJECT VIDA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4875 MAXWELL AVE.
EL PASO TX
79904-1559
US

IV. Provider business mailing address

3607 RIVERA AVE.
EL PASO TX
79905-2415
US

V. Phone/Fax

Practice location:
  • Phone: 915-757-0038
  • Fax: 915-757-1640
Mailing address:
  • Phone: 915-533-7057
  • Fax: 915-533-7158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SCHLESINGER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 915-533-7057