| NPI | 1114791332 |
|---|---|
| Doing Business As | WELLSPACE HEALTH COMMUNITY SUPPORTS |
| Entity Type | Organization |
| Authorized Contact | ALASDAIR JONATHAN PORTEUS Chief Executive Officer 916-550-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X Supports Brokerage | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |