| NPI | 1104859354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI HERNANDEZ Billing Manager 530-226-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 20A7013) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-09-21 |