ACOMA-CANONCITO-LAGUNA INDIAN HEALTH CENTER NPI 1225103922

NPI Information

NPI: 1225103922
Provider Name: ACOMA-CANONCITO-LAGUNA INDIAN HEALTH CENTER

Former Legal Business Name: ACOMA CANONCITO LAGUNA INDIAN

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
80 B VETERANS BLVD
ACOMA, NM
ZIP 87034
Phone: (505) 552-5300
Get Directions

ACOMA-CANONCITO-LAGUNA INDIAN HEALTH CENTER is a health service clinic center in Acoma, NM. ACOMA-CANONCITO-LAGUNA INDIAN HEALTH CENTER NPI is 1225103922. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Acoma Canoncito Laguna Indian.

The provider's business location address is:

80 B VETERANS BLVD
ACOMA, NM
ZIP 87034
Phone: (505) 552-5300
Fax: (505) 552-5490

The provider's authorized official is Delaine Alley .
The authorized official title is Ceo and has the following contact phone number (505) 552-5305.

The CLIA number assigned to this NPI record is 32D0653181 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 3/9/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	320070	OTHER	NEW MEXICO	RAILROAD MEDICARE
2	H3451	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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