| NPI | 1053085316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN HART COO/CFO 408-284-2289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X Supports Brokerage | |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2022-02-16 |