| NPI | 1104194133 |
|---|---|
| Doing Business As | MOBILE HEALTH CENTER- LA CLINICA |
| Entity Type | Organization |
| Authorized Contact | TRACI FOSSEN Cqo 541-512-3912 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2025-11-21 |