| NPI | 1497751572 |
|---|---|
| Other Name | POTAWOT HEALTH VILLAGE |
| Entity Type | Organization |
| Authorized Contact | CECIL PAUL WILSON CFO 707-825-4065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 133N00000X Nutritionist | |
| 152W00000X Optometrist | |
| 251S00000X | |
| 261QC1500X Clinic/Center, Community Health (Licence: CA 11000347) | |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2022-08-24 |