NPI | 1508333253 |
---|---|
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 | 2020-11-02 |