Provider Demographics
NPI:1013143338
Name:YUCCA HEALTH CARE CENTERS
Entity Type:Organization
Organization Name:YUCCA HEALTH CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BENDECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-748-1266
Mailing Address - Street 1:606 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1165
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 NORTH 13TH STREET
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210
Practice Address - Country:US
Practice Address - Phone:806-771-3565
Practice Address - Fax:806-771-3560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care