| NPI | 1477020121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WEBER CEO 209-385-5462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |