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General NPI Number Information
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NPI Number | 1871602698
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CARE CENTER
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 649 HARKLE RD STE E
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City | SANTA FE
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State | NM
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Zip | 87505-4765
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Country | US
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Telephone | 505-955-9454
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Fax | 505-216-9067
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Provider Business Mailing Address
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Address Line | PO BOX 6880
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City | SANTA FE
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State | NM
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Zip | 87502-6880
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Country | US
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Telephone | 505-216-0332
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Fax | 505-989-8131
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL ADAMS
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Credential |
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Telephone | 505-989-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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