Provider Demographics
NPI:1952774796
Name:SOUTHWEST CARE CENTER
Entity Type:Organization
Organization Name:SOUTHWEST CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-989-8200
Mailing Address - Street 1:649 HARKLE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4765
Mailing Address - Country:US
Mailing Address - Phone:505-989-8200
Mailing Address - Fax:505-989-8131
Practice Address - Street 1:901 W ALAMEDA ST
Practice Address - Street 2:SUITE 25
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1681
Practice Address - Country:US
Practice Address - Phone:505-988-8869
Practice Address - Fax:505-982-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X
NM1300029059261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care