Provider Demographics
NPI:1265897151
Name:CLAYTON HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:CLAYTON HEALTH SYSTEMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-374-2585
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:575-374-2273
Mailing Address - Fax:575-374-0903
Practice Address - Street 1:314 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NM
Practice Address - Zip Code:88415-3302
Practice Address - Country:US
Practice Address - Phone:575-374-2273
Practice Address - Fax:575-374-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3060261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health