NPI | 1386299204 |
---|---|
Doing Business As | SAC INDIO CVRM MANILA |
Entity Type | Organization |
Authorized Contact | TASHA AMICK Director Of Billing 909-382-7180 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2019-08-07 |
Last Update Date | 2022-09-01 |