NPI | 1104194133 |
---|---|
Doing Business As | MOBILE HEALTH CENTER- LA CLINICA |
Entity Type | Organization |
Authorized Contact | TARA LYNETTE JEANNOT Chief Operations Officer 541-535-6239 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2011-12-05 |
Last Update Date | 2019-07-15 |