Provider Demographics
NPI:1851861587
Name:CLAYTON HEALTH SYSTEMS, INC
Entity Type:Organization
Organization Name:CLAYTON HEALTH SYSTEMS, INC
Other - Org Name:DES MOINES HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMP
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:575-374-7032
Mailing Address - Street 1:300 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NM
Mailing Address - Zip Code:88415-3304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 FRANCIS AVENUE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:NM
Practice Address - Zip Code:88418
Practice Address - Country:US
Practice Address - Phone:575-278-2619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLAYTON HEALTH SYSTEMS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-26
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty