NPI | 1023650066 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE ABASTA-CUMMINGS CEO 209-850-3542 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-10-10 |
Last Update Date | 2024-04-19 |