| NPI | 1053495879 |
|---|---|
| Other Name | UPPER LAKE CLINIC RHC |
| Entity Type | Organization |
| Authorized Contact | KELLY MATHER CEO 707-262-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |