NPI | 1265030886 |
---|---|
Entity Type | Organization |
Authorized Contact | TONY WEBER CEO 209-384-6493 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-10-15 |
Last Update Date | 2020-10-15 |