| Dhhs/ihs/aao/jsu/dulce Health Center | |
|
12000 Stone Lake Road Jicarilla Service Unit Dulce NM 87528 | |
| (575) 759-3291 | |
| (575) 759-3532 |
| Full Name | Dhhs/ihs/aao/jsu/dulce Health Center |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 12000 Stone Lake Road, Dulce, New Mexico |
| Authorized Official Name and Position | Charlene Hamilton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5757597200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs/ihs/aao/jsu/dulce Health Center P O Box 187 12000 Stone Lake Road Dulce NM 87528-0187 Ph: (575) 759-3291 | Dhhs/ihs/aao/jsu/dulce Health Center 12000 Stone Lake Road Jicarilla Service Unit Dulce NM 87528 Ph: (575) 759-3291 |
| NPI Number | 1548597743 |
|---|---|
| Provider Enumeration Date | 11/09/2009 |
| Last Update Date | 11/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548597743 | NPI | - | NPPES |
| HSZ196 | Other | NM | MEDICARE PART B |
| 000K3526 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | 18451 (Colorado) | Primary |
Jicarilla Health Care Facility Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12000 Stone Lake Rd, Dulce, NM 87528 Phone: 505-759-7286 | |
Dulce Teen Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Hawks Dr, Dulce, NM 87528 Phone: 575-759-2924 Fax: 575-759-1349 | |
Jicarilla Service Unit Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 North Mundo, Dulce, NM 87528 Phone: 505-759-3291 Fax: 505-759-3532 |