| Ena Mitchell Senior And Wellness Center | |
|
532 Demoss St. Lordsburg NM 88045-2618 | |
| (575) 542-2353 | |
| (575) 542-2388 |
| Full Name | Ena Mitchell Senior And Wellness Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 532 Demoss St., Lordsburg, New Mexico |
| Authorized Official Name and Position | Daniel Otero (CEO) |
| Authorized Official Contact | 5755422322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ena Mitchell Senior And Wellness Center 530 De Moss St Lordsburg NM 88045-2618 Ph: (575) 542-2307 | Ena Mitchell Senior And Wellness Center 532 Demoss St. Lordsburg NM 88045-2618 Ph: (575) 542-2353 |
| NPI Number | 1578802518 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 03/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578802518 | NPI | - | NPPES |
| 1 T 3429 | Other | NM | OPERATORS LICENSE |
| 3429 | Other | NM | NM DOH OPERATORS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 3429 (New Mexico) | Primary |
Hms Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 530 De Moss St, Hidalgo Medical Services, Lordsburg, NM 88045 Phone: 575-542-8384 Fax: 575-542-2388 | |
Hms Lordsburg High School Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 W 4th St, Lordsburg, NM 88045 Phone: 575-542-3389 Fax: 575-542-2388 |