NPI | 1063636223 |
---|---|
Entity Type | Organization |
Authorized Contact | ZETTIE D PAGE CEO 510-252-6811 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 140000586) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2007-04-12 |
Last Update Date | 2022-01-31 |