| NPI | 1063280642 |
|---|---|
| Doing Business As | SAC BARSTOW 102 |
| Entity Type | Organization |
| Authorized Contact | TASHA AMICK Director Of Billing 909-219-8665 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2025-04-21 |