Provider Demographics
NPI:1679133011
Name:LA FAMILIA DEL PASO, INC
Entity Type:Organization
Organization Name:LA FAMILIA DEL PASO, INC
Other - Org Name:LA FAMILIA DEL PASO EAST
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-239-2955
Mailing Address - Street 1:1511 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5629
Mailing Address - Country:US
Mailing Address - Phone:915-239-2955
Mailing Address - Fax:915-249-6155
Practice Address - Street 1:1001 N CAROLINA DR STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-2771
Practice Address - Country:US
Practice Address - Phone:915-239-2955
Practice Address - Fax:915-603-3109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LA FAMILIA DEL PASO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-18
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342650401Medicaid