Kewa Pueblo Health Corporation
Kewa Pueblo Health Corporation is a Clinic/Center in Santo Domingo Pueblo, New Mexico. Licensed in New Mexico. Registered with an NPI since 2011.
- Licensed in
- NM
- In the registry since
- 2011
- Specialties on file
- 2
Practice location Address checks out
85 W Highway 22Santo Domingo Pueblo, NM 87052-0559
Phone: (505) 465-3060
Fax: (505) 465-1191
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X |
|---|---|
| Clinic/Center | Taxonomy 261Q00000X · Licence 03217726007 (NM) |
Record details
| NPI number | 1467739888 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Kewa Pueblo Health Corporation |
| Authorized official | Jimmie Charlie — Chief Medical Officer · (505) 465-3060 |
| Other names | Santo Domingo Health Center; Santo Domingo Health Center |
| NPI enumerated | November 14, 2011 |
| Last updated in NPPES | February 22, 2024 |
| Certification date | February 22, 2024 |
| Mailing address | Po Box 559, Santo Domingo Pueblo, NM 87052-0559 |