| NPI | 1255347894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL PETERSEN CFO 760-736-8699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-08-12 |