| NPI | 1083611156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY HYDASH President CEO 559-737-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 120000590) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2022-04-26 |