Jicarilla Health Care Facility
NPI #1003820069 in Dulce, New Mexico
Provider Information
- NPI Number
- 1003820069
- Entity Type
- Organization
- Organization Name
- Jicarilla Health Care Facility
- Primary Specialty
- Clinic/Center - Community Health
- Enumeration Date
- Jul 27, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 12000 STONE LAKE RD
- City
- Dulce
- State
- New Mexico
- ZIP Code
- 87528
- Phone
- (505) 759-7286
Authorized Official
- Name
- MR. THOMAS T PRYOR, RN
- Title
- PUBLIC HEALTH NURSE
- Phone
- (505) 759-7286
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Community Health — Community Health |
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